A white paper released by MedeAnalytics shows health insurance plans should benefit from the proposed rule on accountable care organizations.
The ACO rule, released April 1 by the Department of Health and Human Services, contains most of the provisions sought by the health insurance lobby, the MedeAnalytics analysis concluded.
"The proposed rule positively addresses many of the concerns the major payer organizations expressed in their responses to the Nov. 17, 2010 CMS' ACO request for information," said Dan West, product marketing manager and member of MedeAnalytics' healthcare policy team. "It bodes well for private-sector efforts to establish similar initiatives transforming the healthcare system."
According to MedeAnalytics, the ACO label has been around since 2006, was mentioned in numerous healthcare reform bills proposed in 2009 and was ultimately included in Section 3022 of the Affordable Care Act as the Medicare Shared Savings Program.
The ACA's ACO provision covers Medicare ACOs. The Shared Savings Program is a new approach to the delivery of healthcare aimed at better care for individuals, better health for populations and lower growth in healthcare expenditures, MedeAnalytics researchers said.
The proposed rule specifies 65 quality measures, of which 58 overlap with one or more other quality reporting programs, the white paper found. The other quality measurement programs include the Agency for Healthcare Research and Quality Prevention Quality Indicators and Patient Safety Indicators, the Healthcare Effectiveness and Data Information Set, Meaningful Use Stage 2, the Physician Quality Reporting System and the Value-Based Purchasing program.
"The high degree of commonality for quality measures should help ACOs meet the Shared Savings Program's Year 1 quality performance standards, since healthcare providers are quite familiar with their nature, required data collection methods and reporting processes," said Mino Sastry, product marketing manager for MedeAnalytics' provider solutions.
MedeAnalytics is an Emeryville, Calif.-based healthcare performance management firm that aims to collect and analyze data to help hospitals, physician practices and payers ensure accountability and improve financial, operational and clinical outcomes, a key element of successfully managing ACOs.
The white paper is available to those who register online at the MedeAnalytics ACO resource center .
[See related stories: ACOs key to healthcare overhaul, Berwick says; Payers, providers agree - and disagree - on ACOs.]