AMA Releases ACO Guidelines
John Commins, for HealthLeaders Media, November 12, 2010
- Physician and patient participation in an ACO should be voluntary. Patient participation in an ACO should be voluntary rather than a mandatory assignment to an ACO by Medicare. Any physician organization or any other entity that creates an ACO must obtain the written consent of each physician to participate in the ACO. Physicians should not be required to join an ACO as a condition of contracting with Medicare, Medicaid or a private payer or being admitted to a hospital medical staff.
- The savings and revenues of an ACO should be retained for patient care services and distributed to the ACO participants.
- Flexibility in patient referral and antitrust laws. Federal and state anti-kickback and self-referral laws and the federal Civil Monetary Penalties statute should be flexible to allow physicians to collaborate with hospitals in forming ACOs without being employed by the hospitals or ACOs. This is particularly important for physicians in small- and medium-sized practices who may want to remain independent but otherwise integrate and collaborate with other physicians in the ACO.
John Commins is a senior editor with HealthLeaders Media.
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