Douglas Hastings, Chair of the Board of Directors and a Member of the Firm's Health Care and Life Sciences practice, in the Washington, DC, office, comments on ACOs under the Medicare Shared Savings Program (MSSP) proposed rule, in a blog post titled "Pioneer ACOs: Surging to a New Level of Integration?"

Following is an excerpt:

In a speech on February 1, among other comments, Dr. Don Berwick, the Administrator for the Centers for Medicare and Medicaid Services, had the following to say about accountable care organizations under the Medicare Shared Savings Program ("MSSP") Proposed Rule, which was subsequently released on March 31:

The proposed rule will be a core model. It will be what anybody can play with. But we all know there are places out there that are ready to surge ahead to a completely different level of integration. They've been there already or are en route. Wouldn't it be nice if we had made a space for a vanguard, who can move ahead of the pack and teach us all the way to go? Maybe the Innovation Center can be a home for that kind of pioneering element on our behalf, on everyone's behalf. Not specially entitled players, but our scouts.

Within two weeks of the Proposed Rule's issuance, one could hear the national ACO balloon deflating as a result of wholesale and widespread criticism of the Proposed Rule, including negative comments from many of the original champions of accountable care. Some of this negative reaction was the result of organizations new to the ACO concept not understanding the complexity and level of effort it will take to transform the delivery system into a more coordinated and accountable one. But much of it was due to legitimate criticism by knowledgeable policy and industry experts of elements of the Proposed Rule. CMS has strongly indicated that changes will be made to accommodate some of the concerns in the final rule, due late summer.

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