(ACO) regulations - American Society of Anesthesiologists

CMS-1345-P 26
workforce, including affiliated clinicians. It will maintain and execute plans for helping
build skill, knowledge, and teamwork.
As proposed in this notice of proposed rulemaking (NPRM), the Shared Savings
Program encourages providers of services and suppliers to form ACOs that seek to
achieve a three-part aim of better care for individuals, better health for populations, and
lower growth in expenditures. The proposed rule establishes the requirements for ACOs
to take responsibility for improving the quality of care they deliver to a group of
Medicare FFS beneficiaries, while lowering the growth in costs, in return for a share of
the resulting savings. In addition to establishing a shared savings model for rewarding
quality and financial performance, the program also holds ACOs accountable for excess
expenditures by establishing, as an option, a two-sided risk model which requires
repayment of losses to us. This represents a new approach for the Medicare FFS
program, under which providers have traditionally had little or no financial incentive to
coordinate the care for their patients or to be accountable for the total costs and quality of
the care provided.
Since there is little comparative experience with implementing a Shared Savings
Program and alternative payment models at the national level, we sought input on the
impact of this proposed program from a wide range of external experts, including
credentialed actuaries, clinical managers, and academic researchers on the potential
impact of the program through, for example, the White House meeting, multiple listening
sessions, Special Open Door Forum on ACOs, Workshop Regarding ACOs with CMS,
OIG, and the Antitrust Agencies, and a Request For Information. Incorporating their
input, we estimate that up to 5 million Medicare beneficiaries will receive care from