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2011 Annual Education Program

The 2011 AMA-OMSS Annual Meeting was held June 16-18, 2011, in Chicago. Continuing medical education (CME) credit is still available for those programs marked with an asterisk (*).

An Update on Accountable Care Organizations

CME credit is no longer available for this program.

Faculty

  • Henry Allen, MPA, JD
  • Elias Matsakis, JD

Description

The American Medical Association (AMA) adopted ACO principles on November 9, 2010, at its Interim Meeting in San Diego. The Association is advocating that participation by physicians be voluntary and that barriers for small practices to participate be eliminated. This program will discuss the soon to be released accountable care organization regulations and related issues (e.g. Antitrust). These regulations, will determine how ACOs qualify for CMS' shared savings program in 2012. In addition, the program will explain how ACOs are intended to help physicians and others, including hospitals, coordinate and provide effective quality care. Finally, the program will describe the new nonprofit, member-run health insurer ("CO-OP") program that provides federal loans and grants for start-up insurers that physicians and others might establish and operate, and that may collaborate with physician-driven ACOs.

Learning Objectives

  1. Describe what accountable care organizations (ACOs) are and the types of issues with which physicians will most likely grapple with when considering ACO participation.
  2. Discuss the Accountable Care Organization (ACO) Regulations.
  3. Describe the tools necessary to participate in ACOs.
  4. Discuss managing the antitrust ramifications of ACO formation and physician joint contracting with payors.
  5. Describe many of the specific issues that physicians must consider when deciding whether or not to create an ACO with hospital partners.
  6. Identify some of the key issues that should be considered by physicians deciding whether or not to partner with hospitals or health insurers to create an ACO.
  7. Discuss what CO-OPs are; the new opportunities for CO-OPs that now exist in a post-health reform world, and what those new opportunities may mean for physicians.

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