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A Primer on Accountable Care Organizations

To participate in this CME activity: (1) review the information on this page which includes the learning objectives and faculty disclosures; (2) read the course pages; (3) complete the exam; (4) view/print certificate.

Course Information

General Information

• If you need to stop in the middle of a course, you may return to the course at anytime to finish.
• When you have finished reading the course pages click on CME Exam in the Course Sections box (top right).
• To begin this CME activity, read through the information on this page and then click on the Start Course button.

Course Overview

The Affordable Care Act (ACA) which became law on March 23, 2010 established an Accountable Care Organization (ACO) program for Medicare which is scheduled to begin in January 2012.  The way in which physicians practice medicine and operate their business could undergo significant change.  Many "unknowns" regarding the legal, risk and liability aspects of ACOs will impact the small physician practice. Understanding the current laws, environment and research will enable physicians to make informed decisions about his or her participation in ACOs.

At this time, it is unclear how many state and federals laws such as: the Stark Law, anti-kickback statute and antitrust laws will impact the formation and operation of ACOs.  Insurance, tax issues and professional liability are also under close scrutiny to determine the risk and responsibilities of the individual provider. This CME activity defines Accountable Care Organizations (ACOs) and the impact they could potentially have on physicians and patients.  

Intended Audience

This course is intended for physicians and allied health professionals.

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Course Objectives

• Provide physicians and other practitioners with an understanding of the genesis of Accountable Care Organizations (ACOs).
• Describe the proposed models of ACOs under The Patient Protection and Affordable Care Act of 2010.
• Cite some potential medical-legal issues that physicians may face with the proliferation of ACOs.

Course Credit

Deadline for completing the course is March 30, 2012.

The Massachusetts Medical Society designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

This program meets the criteria of the Massachusetts Board of Registration in Medicine for risk management study.

Participants will receive a confidential report of their examination score. You must receive a score of 70% or better to receive AMA PRA Category 1 Credit™.  A confirmation of credit will be issued at the end of the course to those who successfully complete the examination.

Each activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the Joint Sponsorship of the Massachusetts Medical Society and Lawyers Weekly, Inc., publisher of Massachusetts Medical Law Report.

The Massachusetts Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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Course Fees

A Primer on Accountable Care Organizations and all associated course materials are available free of charge. An opportunity to complete an exam and receive AMA PRA Category 1 Credit™ for a nominal fee is available at the end of the course. The course fees are as follows:

Massachusetts Medical Society (MMS) Member: $10 ($10 per credit)

Non-MMS member: $20 ($20 per credit)

Disclosure/Commercial Support

The following course content developers have no financial interests or relationships to disclose.

Henry Tulgan, MD, FACP
Reni Gertner, MPH, Editor Lawyers Weekly
Craig Schneider, PhD, Director of Healthcare Policy, MHDC
Kathleen Bellisle, Manager of MMS Distance Learning
Thelma Tatten, Program Coordinator, MMS Distance Learning

Off-label Disclosure

This course does not include any discussion of an off-label use of a commercial product or an investigational use not yet approved for any purpose by the FDA.

Commercial Support

No commercial support was received for this online program.

Content Disclaimer

The Massachusetts Medical Society does not take responsibility for the accuracy of the information in this CME program, which was provided by Lawyers Weekly, Inc. and summarized by Henry Tulgan, MD, FACP. The views expressed are not necessarily those of the Massachusetts Medical Society.

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Online Course Developers

Henry Tulgan, MD, FACP
Reni Gertner, MPH, Editor Lawyers Weekly
Kathleen Bellisle, Manager of MMS Distance Learning
Thelma Tatten, Program Coordinator, MMS Distance Learning

Bibliography

1. Rosenthal, PhD, Meredith B. “Towards a Shared Vision of Payment Reform,” Harvard School of Public Health. Written for the Massachusetts Medical Society, January 2011
2. Coombs, MD, Alice, “For physicians, ACOs present substantial legal issues,”  Massachusetts Medical Law Report, Dec. 27, 2010. 
3. Iglehart, JK.“Assessing an ACO Prototype-Medicare’s Physician Group Practice Demonstration.” New England Journal of Medicine2011; 364:198-200, Jan. 20, 2011
4. Medicare “Accountable Care Organizations” Shared Savings Program – New Section 1899 of Title XVIII
   Preliminary Questions & Answers
   CMS Office of Legislation
5. Leibenluft, J.D., Robert F.,“ACOs and the Enforcement of Fraud, Abuse, and Antitrust Laws.”New England Journal of Medicine 2011; 364:99-101, Jan. 13, 2011
   NEJM Search, ACO
6.  Lieberman, Steven M.; and Bertko, John M.,“Building Regulatory And Operational Flexibility Into Accountable Care Organizations And ‘Shared Savings.’” Health Affairs, January 2011. 30:123-31; doi:10.1377/hlthaff.2010.0928
7. Goldsmith, Jeff, Analysis & Commentary: “Accountable Care Organizations: The Case For Flexible Partnerships Between Health Plans And Providers.”  Health Affairs, January 2011. 30:132-40; doi:10.1377/hlthaff.2010.0782
8. DeVore, Susan; Champion, R. Wesley, “Driving Population Health Through Accountable Care Organizations.” Health Affairs, January 2011 30:141-50; doi:10.1377/hlthaff.2010.0935
9. Chernew, Michael E.; Mechanic, Robert E.; Landon, Bruce E.; Gelb Safran, Dana, “Private-Payer Innovation In Massachusetts: The ‘Alternative Quality Contract.’” Health Affairs, January 2011 30:151-61; doi:10.1377/hlthaff.2010.0980
10. “The Accountable Care Organization: Not Ready For Prime Time.”Health Affairs Blog post by Jeff Goldsmith on Aug. 17, 2009
    http://healthaffairs.org/blog/2009/08/17/the-accountable-care-organization-not-ready-for-prime-time/print/ 
11. The Dartmouth Atlas of Health Care
    http://www.dartmouthatlas.org/
12. The American Medical Association.“ACOs, CO-OPs and other Options: A "How-To" Manual for Physicians Navigating a Post-Health Reform World.”
13. Cohen, Jordan T.,  “A Guide to Accountable Care Organizations, and Their Role in the Senate’s Health Reform Bill,” Health Reform Watch, March 11, 2010.
14. Fisher, Elliott S.; Staiger, Douglas O.; Bynum , Julie P.W. ; Gottlieb, Daniel J. “Creating Accountable Care Organizations: The Extended Hospital Medical Staff .”Health Affairs, 26, no. 1 (2007): w44-w57. (Published online) doi: 10.1377/hlthaff.26.1.w44
15. The Accountable Care Organization Learning Network
    www.acolearningnetwork.org 
16. Shortell, PhD, M.B.A., M.P.H., Stephen M.; Casalino, MD, PhD, Lawrence P., “Accountable Care Systems For Comprehensive Health Care Reform”
17. Health Care Incentives Improvement Institute, “What is PROMETHEUS Payment?”

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Hardware & Software Requirements

Supported Browsers
Internet Explorer v.7 or greater (for Windows)
Mozilla Firefox v.2 or greater (for Windows, Mac, Linux)

Minimum System Requirements

Windows Systems Requirements
A Pentium-based PC or compatible computer.
At least 64MB of RAM.
Windows 95/98/NT/ME/2000/XP/Vista system software.
Screen resolution of 1024 x 786 or larger recommended
PDF Reader: Adobe Reader 5.0 or higher, Foxit Reader 2.0 or likewise.

Mac OS System Requirements
A PowerPC processor-based Macintosh computer.
At least 64MB of RAM.
Mac OS 7.5 or later.
Screen resolution of 1024 x 786 or larger recommended.
PDF Reader: Adobe Reader 5.0 or higher, Foxit Reader 2.0 or likewise.

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Contact Us

Contact us at continuingeducation@mms.org or (800) 322-2303, ext. 7306. Massachusetts Medical Society, 860 Winter Street, Waltham, MA 02451.

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