Med­i­cal as­so­ci­a­tions re­lease joint ACO prin­ci­ples

Modern Healthcare - - Late News -

The Amer­i­can Academy of Fam­ily Physi­cians, the Amer­i­can Academy of Pe­di­atrics, the Amer­i­can Col­lege of Physi­cians and the Amer­i­can Os­teo­pathic As­so­ci­a­tion be­came the lat­est med­i­cal as­so­ci­a­tions to re­lease prin­ci­ples for emerg­ing net­works known as ac­count­able care or­ga­ni­za­tions. The groups re­leased a jointly en­dorsed list of struc­tural and pay­ment prin­ci­ples for devel­op­ment of ACOs. Medi­care will be­gin to pay providers in 2012 un­der the ac­count­able care model, which is broadly de­fined as provider net­works that are el­i­gi­ble for bonus pay­ments tied to qual­ity and cost-con­trol tar­gets. Providers and com­mer­cial in­sur­ers also have an­nounced ef­forts to cre­ate ACOs out­side of Medi­care. The prin­ci­ples re­leased by the four physi­cian groups called for “sig­nif­i­cant and eq­ui­table” rep­re­sen­ta­tion of pri­mary care and spe­cial­ists in ACO lead­er­ship. ACO or­ga­ni­za­tion, ad­min­is­tra­tion and clin­i­cal and le­gal pro­cesses, in­clud­ing pay­ment and risk ad­just­ment, should be pub­lic, the groups said. The groups en­dorsed the use of mul­ti­ple pay­ment mod­els, in­clud­ing par­tial cap­i­ta­tion, but said doc­tors and other pro­fes­sion­als who do not clearly agree to “in­surance risk” should be pro­tected from such a risk.

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