 J.D., New York University School of Law; Research Fellow & Lecturer in Law, Center for Health & Pharmaceutical Law & Policy, Seton Hall University School of Law. The author was a member of a working group in New Jersey that collaborated to identify issues to assist the State in its drafting of regulations to implement its Medicaid Accountable Care Organization (ACO) legislation, which is the ...

Creating accountable care organizations (ACOs) has been widely discussed as a strategy to control rapidly rising healthcare costs and improve quality of care; however, building an effective ACO is a complex process involving multiple stakeholders (payers, providers, patients) with their own interests. Also, implementation of an ACO is costly in terms of time and money. Immature design could cau...

Amid the political banter that continues to surround the Patient Protection and Affordable Care Act, or Obamacare, 32 accountable care organizations (ACOs) participating in CMS’s Pioneer ACO Model dove in headfirst to see if this new model for aggregating, coordinating, and financing health care accomplishes the stated goals of the Institute for Healthcare Improvement’s Triple Aim Initiative [1...

The concept of "alignment" between physicians and hospitals is a popular buzzword in the age of health care reform. Despite their often tumultuous histories, physicians and hospitals find themselves under increasing pressures to work together toward common goals. However, effective alignment is more than just simple cooperation between parties. The process of achieving alignment does not have s...

W e are in the midst of a tumultuous time in health policy. As new payment models gradually replace fee-for-service systems, new quality metrics proliferate, and costs of care become a bona fide health outcome, expensive imaging and procedures face increasing scrutiny. Responsible for >$300 billion in medical spending in 2010, 1 more than any other diagnostic group, cardiovascular disease is un...

Purpose. This policy brief continues the work of the RUPRI Center analyzing the performance of Medicare Accountable Care Organizations (ACOs) serving rural areas. In this brief, we examine the differences in performance on four domains of quality measures and the overall quality score among Medicare Shared Savings ACOs with different levels of rural presence. Key Findings. (1) ACOs located in r...

Although United States health care costs are significantly higher than any other industrialized country, we still lag behind many countries in health care equity and quality metrics. One feature of the Affordable Care Act that intended to address this was the establishment of Accountable Care Organizations (ACO). ACOs create a network of physicians that ostensibly will enhance care coordination...

With the passage of the Affordable Care Act (ACA) in 2010, broad agreement has been reached on the need for fundamental reform of healthcare delivery and payment systems. Accountable care organizations (ACOs) have become one of the most discussed provisions of the ACA, and Medicare's Shared Savings Program (SSP), the incentive program tied to ACOs, has the potential to change the delivery of he...