Considerations for the Development of Accountable Care Organizations in New York State

A new NYHealth report, “Considerations for the Development of Accountable Care Organizations in New York State,” provides a framework for State officials and health care industry stakeholders to consider the policy issues raised by the development of Accountable Care Organizations in New York.

The Federal health reform law created a wide range of initiatives designed to transform how health care is provided and financed throughout the country. One approach attracting tremendous attention is the Medicare Shared Savings Program, which provides a legal framework and a set of financial incentives for groups of providers to participate in an Accountable Care Organization (ACO).

The emerging ACO model—in which a group of health care providers are responsible for the total cost and quality of care for a defined population of patients—raises a number of technical and policy issues for New York State’s policymakers, health care providers, and payers: How do existing State regulations support or impede the development of ACOs? How might the current health insurance market and health care delivery landscape in New York State affect the evolution of ACOs, and how will ACOs change that landscape? What kinds of policies and incentives might be needed to stimulate participation in the model? Are ACOs the right vehicle for transforming the system?

The NYHealth report, prepared by Manatt, Phelps & Phillips, LLP, examines these key questions.