Antitrust Agencies Propose "Safety Zone" For Accountable Care Organizations

Under the Patient Protection and Affordable Care Act, physicians, hospitals and other health care providers are encouraged to form collaborative care groups, called Accountable Care Organizations ("ACOs"), to provide innovative services to reduce costs and improve quality of patient care. The Affordable Care Act created the Medicare Shared Savings Program under which ACOs may share in any savings they create for Medicare beneficiaries if the ACOs meet quality performance standards established by the Secretary of Health and Human Services through the Centers for Medicare & Medicaid Services ("CMS").¹

Under a companion CMS proposed rule, independent providers are permitted to qualify as an ACO if the organization has (i) a formal legal structure that allows it to receive and distribute payments for shared savings, (ii) a leadership and management structure that includes clinical and administrative processes, (iii) processes to promote evidence-based medicine and