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CMS releases proposed ACO rules
65 quality measures included
The proposed rules for accountable care organizations (ACOs) were released at the end of March, and Donald Berwick, MD, administrator for the Centers For Medicare & Medicaid Services, lost no time writing about their potential import in the New England Journal of Medicine1. The rules are designed to help groups create new organizations for caring for specific Medicare populations in the hopes that they can provide better care, as well as lower the cost of care or at least the rate of growth in costs. Berwick hopes that ACOs will not only save money, but mark the death knell for fragmented care.
This may seem like nothing that matters to quality improvement staff at the local hospital, but you need to be involved in the process, says Kathy Heilig, RN, MSN, a consultant in North Carolina who has 17 years experience working for the NC Hospital Association. "Hospitals are connecting with physician practices because of this," she says. "That means that more and more physician offices will be relying on hospital quality people to get to where they need to be to meet the proposed quality goals."
There are some 65 quality measures in five measure domains for quality performance standards for ACOs, according to the proposed rules. (See the complete rule at http://www.federalregister.gov/articles.)
The quality measures include several categories:
In a future issue of HPR, look for extended coverage on exactly how hospitals can prepare for the ACO reality and the quality goals they require.
For more information on this story, contact Kathryn Heilig, RN, MSN, consultant. Telephone: (919) 851-7533. Email: firstname.lastname@example.org.
Berwick DM. Launching accountable care organizations: the proposed rule for the Medicare shared savings program. N Engl J Med. 2011 Mar 31.