Accountable Care Organizations in Medicare and the Private Sector

This policy paper examines the latest developments in accountable care organizations (ACOs), including a look at the final regulations on ACOs issued in October 2011 by the Centers for Medicare & Medicaid Services (CMS). The paper, written by the Urban Institute, provides an overview of ACOs, the key complaints about CMS’ proposed regulations and their resolution in the final regulations, and the status of adoption of this new model for delivering health care by both Medicare and private health insurance plans.

The paper notes that so far, the reception to CMS’ final regulations has been positive, but how many organizations will actually apply to CMS to be ACOs is another question. By the end of 2012, the authors explain that we should know how successful CMS’ program was in attracting provider interest in the ACO model in Medicare, and how extensively the private sector plans to experiment with this payment model.