The final rule establishing a framework for accountable care organizations (ACOs) was released by the Centers for Medicare and Medicaid in October. The final rule reflects changes to the proposed rule to accommodate criticism received regarding timelines, quality measure reporting and incentives. Under the final rule, eligible providers can choose from multiple start dates in 2012 with a “rolling” application process.  In addition, providers are required to report on 33 quality measures in four domains as opposed to 65 measures in five domains

CMS also increased the financial incentives for providers. Under accountable care, providers that meet certain quality and cost-saving targets are eligible for a share of the savings. Bonuses paid to providers could reach up to $1.9 million. ACOs are expected to save Medicare up to $940 million over a four-year period. Overall, response to the final rule reflected the desire for long-term care to be a part of the ACO mission.