Today , Governor Patrick released proposed legislation “Improving the Quality of Health Care and Controlling Costs by Reforming Health Systems and Payments.” The bill calls for “Encouraging the formation of integrated care organizations, commonly referred to as accountable care organizations, comprised of connected or integrated groups of health care providers that achieve improved health outcomes and lower the costs of care.
The bill does not explicitly define provides and services that must be encompassed in an ACO instead defining an ACO as “an entity comprised of provider groups which operates as a single integrated organization that accepts at least shared responsibility for the cost and primary responsibility for the quality of care delivered to a specific population of patients cared for by the groups’ clinicians; which operates consistent with principles of a patient centered medical home and satisfies the other requirements of this chapter; which has a formal legal structure to receive and distribute savings; The bill does anticipate that “certain providers that are not primary care providers may be ACO network providers in more than one ACO, as set forth in regulation by the division.” The “division” which has authority to draft authorizing regulations is the Division of Health Care Finance & Policy.
The bill calls for greater transparency in payment arrangements and requires that by March 31, 2012, the “Division will “document, categorize and publish all current payment arrangements in the commonwealth between payers and providers.” Medicaid participation in the ACO model is envisioned by 2014.
The Alliance will be reviewing this legislation with the Legislative and Policy Committee and the Board of Directors and welcomes member feedback. as to whether home health’s role should be more explicit in this legislation.
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