ABA Health eSource June 2011 Volume 7 ACO Special Edition
ABA Health eSource - Your link to the ABA's Health Law Section
June 2011 Special Edition
Health Law Section NewsJune 2, 2011

June 9, 2011
Employee Benefits in Mergers and Acquisitions
(CLE Webinar & Teleconference)

June 14, 2011
Group Health Claims & Appeals: The Brave New World for Making, Administering & Paying Health Claims
(CLE Webinar & Teleconference)

June 16, 2011
Fundamentals of Medical Staff & Peer Review Issues
(CLE Webinar & Teleconference)

Health Law Highlights

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ACO Special Edition of eSource

With the recent publication of the proposed regulations and commentary on Accountable Care Organizations (ACOs), the ABA eSource Editiorial Board in conjunction with the Section's ACO Task Force has decided to publish a series of Special Editions focused on ACOs. This is the second special edition of eSource, with more information on the first special edition available below. If you are interested in writing an article on a topic related to ACOs, please contact Simeon Carson, Associate Director, directly at simeon.carson@americanbar.org.

The ACO Task Force, chaired by Matthew Jenkins, Partner, Hunton & Williams LLP, was formed to address the myriad issues that surround the development of accountable care organizations, both in response to the provisions of PPACA and the interest of commercial payors in finding new ways to bend the cost curve. The Task Force has plans for several related projects in the coming months.

Membership in the the ACO Task Force is free for Health Law Section members. To join, please click here or contact Simeon Carson, Associate Director, at simeon.carson@americanbar.org.


The Importance of Health Information Technology for Accountable Care Organizations
By Amy K. Fehn, Wachler & Associates, P.C., Royal Oak, MI 

The proposed rule for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP), published by CMS in the Federal Register on April 7, 2011 highlights the important role that health information technology will play in the ability of ACOs to meet eligibility criteria and successfully participate in the MSSP.

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ACO mission: Behavioral Healthcare Under the Medicare Shared Savings Program
By David K. Ries, Human Capital Specialists, Inc., San Diego, CA 

The promotion of Accountable Care Organizations (ACOs) – a new model for delivering healthcare services at reduced costs - is an exciting aspect of the Patient Protection and Affordable Care Act (PPACA). The potential for this reform will be demonstrated primarily through the Medicare Shared Savings Program (MSSP), which is described in proposed regulations published by the Centers for Medicare & Medicaid Services (“CMS”) on April 7, 2011. The influence of the ACO regulations on the nation’s health system will extend beyond the MSSP. As risk-bearing entities, ACOs require capitalization, so hospitals and physician groups are partnering with insurers to form these entities

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A Historical Framework for Accountable Care Organizations: Will CMS Meet Its Long-Term Goals with this Initiative?
By Jeffrey D. Zigler, Director, Global Health Economics, Reimbursement & Public Policy, Musculoskeletal Clinical Regulatory Advisers, LLC (MCRA)

On March 31, the Centers for Medicare & Medicaid Services (CMS) announced proposed rules which would establish and govern Accountable Care Organizations (ACOs) to “ improve coordination and communication among doctors and hospitals, improve the quality of the care their patients receive, and help lower costs” by incentivizing providers through a cost-sharing program with CMS, according to Kathleen Sebelius, Secretary of Health and Human Services (HHS). The three-part aim of ACOs is to provide 1) better care for individuals, 2) better health for patients, and 3) lower growth in expenditures. The ACO program will ideally achieve cost reduction for the Medicare Program, as well as establish quality metrics for enhanced clinical care, as part of CMS’ value based purchasing initiatives.

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First ACO Special Edition of eSource

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Did you know membership in an interest group is FREE with your Health Law Section membership?

Did you know your membership in the ABA Health Law Section qualifies you for free membership in up to three interest groups of your choice? Interest groups, which are comprised of twelve practices areas within health law, make significant contributions to the Section's programming, publications and legislative initiatives. The interest groups also provide an excellent opportunity for you to interact with and have access to some of the most outstanding lawyers in the legal community. You can enroll on our webpage by clicking here. If you have any questions or need more information, please contact Simeon Carson at simeon.carson@americanbar.org


ACO Task Force

The ACO Task Force was formed to address the myriad issues that surround the development of accountable care organizations, both in response to the provisions of PPACA and the interest of commercial payors in finding new ways to bend the cost curve.

The Task Force is led by Chair Matthew Jenkins, Hunton & Williams LLP, Richmond, VA and Vice-Chairs William Boyd, Baylor Health Care System, Dallas, TX; Bernadette M. Broccolo, McDermott Will & Emery LLP, Chicago, IL and Robert F. Leibenluft, Hogan Lovells, Washington, DC.

If you would like to join the Interest Group, continue by clicking the following link: Health Law Section IG Sign-up Form.


ABA eSource Editorial Board

The ABA Health eSource Editorial Board is led by Chair Lisa Genecov, Locke Lord Bissell and Liddell LLP, Dallas, TX and editorial board members Michael E. Clark, Duane Morris LLP, Houston, TX; Adrienne Dresevic, The Health Law Partners, PC, Southfield, MI; Marla Durben Hirsch, Potomac, MD; Conrad Meyer, Chaffe McCall, LLP, New Orleans, LA and Jennifer Tsao, Hernandez Schaedel & Associates LLP, Pasadena, CA.


Do you want to communicate your ideas to thousands of other members? To contribute a newsletter article on a health law topic, send us your ideas to simeon.carson@americanbar.org.
The opinions expressed are those of the authors and shall not be construed to represent the policies or positions of the ABA or the ABA Health Law Section.
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