A new policy paper from the Urban Institute examines a range of issues surrounding accountable care organizations, including Medicare's recently released final ACO rule.

The paper covers the concept and history of ACOs, current status of government and private initiatives, and the substantial changes in the final rule following significant provider concerns. The authors also consider whether ACOs will save money, increase care quality, raise prices for private insurers, and spread rapidly.

"It remains unsettled whether the primary purpose of the Medicare Shared Savings Program and companion Pioneer ACO model should be to test the ACO concept to see if it is broadly scalable to diverse providers, whether or not it generates substantial early savings to the government, or whether the goal of the program should be to move as many providers into the program as soon as possible to satisfy political pressures to slow the growth in Medicare spending," according to the report. "In its final regulations, CMS seems to be adopting the former viewpoint."

The Robert Wood Johnson Foundation supported development of the 12-page paper, "Accountable Care Organizations in Medicare and the Private Sector: A Status Update," available for free here.


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