Expanding Health Care Coverage

Grantee Name

Manatt Health Solutions

Funding Area

Expanding Health Care Coverage

Publication Date

August 2012

Grant Amount

$40,000

Grant Date:

April 2011–August 2011

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The Accountable Care Organization (ACO) is a promising new model to slow rising health care costs and improve quality of care.

An ACO formally brings together a set of non-affiliated providers, ideally including primary care physicians, specialists, community health centers, hospitals, and post-acute care providers, and holds them accountable for the cost and quality of care delivered to a defined population of patients. With support from NYHealth, Manatt Health Solutions analyzed Federal regulations released in April 2011 that addressed legal issues facing ACOs. Manatt also produced a report.

Outcomes and Lessons Learned

  • Analyzed the proposed ACO regulations (released by CMS in April 2011), as well as the proposed “Pioneer Model” regulations (released in May 2011) for organizations with experience in coordinating care and accepting risk-sharing arrangements.
  • Examined the implications of these regulations, with a lens to the current New York health care and regulatory landscape.
  • Produced a June 2011 report titled, “Considerations for the Development of Accountable Care Organizations in New York State.”
  • Featured highlights of the report’s analysis in an electronic newsletter sent to 3,800 national and State legal experts, researchers, and policymakers.
  • Found that fragmentation in New York’s health care market may present a barrier to the implementation of ACOs.
  • Determined that the proposed ACO rules do not preempt State laws and regulations; thus, the development of ACOs must comply with New York’s existing statutes and regulations.