Last week, CMS released its final rule governing accountable care organizations (ACO) .

The federal health reform law requires federal health programs to begin contracting with ACOs starting in January 2012. ACOs aim to lower costs and improve care by fostering cooperation between physicians, hospitals and other providers. HHS estimates that ACOs will save Medicare between $510 million and $960 million during the first three years.

CMS released proposed ACO rules over the summer. However, the response from stakeholders were mostly unfavorable. Comments ranged from requesting that the management of ACOs should be simplified to arguing that rule creates too many bureaucratic and legal hurdles. Groups also commented that the number of quality standards will require excessive data management and are worried that potential savings are limited.

Other changes include:

  • Expanding participation of Rural Health Clinics and Federally Qualified Health Centers;
  • Providers must meet 33 quality metrics — down from 65 — to qualify for performance bonuses; and
  • A more flexible application timetable, which allows providers to seek ACO status through 2012.