Structuring Medicaid Accountable Care Organizations to avoid antitrust challenges.

Accountable care organizations: Implications for antitrust policy

Introduction T his analysis examines accountable care organizations (ACOs) and assesses their implications for antitrust policy. Consideration of the antitrust implications of ACOs is timely. Both the House and Senate health reform measures contemplate the creation of ACOs as a new class of Medicare provider while providing parallel legal authority under Medicaid. It also is possible that using...

Early experiences with accountable care in Medicaid: special challenges, big opportunities.

Accountable care organizations (ACOs) and the more general movement toward accountable care, in which payments are aligned directly with improvements in quality and cost, are intended to increase the incentives and support for higher value in health care. As of mid-2013, there are over 4 million beneficiaries covered by Medicare ACOs, and large private payers continue to enter new ACO arrangeme...

FEDERAL TRADE COMMISSION DEPARTMENT OF JUSTICE Antitrust Division Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program

1 Health Care and Education Reconciliation Act of 2010, Public Law 111–52, 124 Stat. 1029 (2010); Patient Protection and Affordable Care Act, Public Law 111–48, 124 Stat. 119 (2010). 2 As used in this document, ‘‘ACO’’ refers to Accountable Care Organizations under the Medicare Shared Savings Program, which also may operate in commercial markets. Patient Protection and Affordable Care Act 3022,...

An antitrust analysis of accountable care organizations: potential abuses from allowing reduced scrutiny under the Affordable Care Act.

Structuring Incentives within Accountable Care Organizations by

Accountable Care Organizations (ACOs) are a new model for integrated health care delivery created by the Patient Protection and Affordable Care Act. They allow a group of hospitals and providers to jointly contract with the Center for Medicare and Medicaid Services to provide care to a population of Medicare enrollees in an environment that rewards cost-efficiency through shared savings so long...