WASHINGTON and NEW YORK – A new policy research brief from the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services examines the impact on medically underserved Medicare beneficiaries of CMS’ proposed rule implementing the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs).

The report, titled “Medicare’s Accountable Care Organization Regulations: How Will Medicare Beneficiaries who Reside in Medically Underserved Communities Fare?” finds that the regulation excludes from the anticipated benefits of ACO growth over 1.4 million Medicare beneficiaries who receive their primary care from federally qualified health centers (FQHCs). The exclusion arises from an interpretation of the law by the Centers for Medicare and Medicaid Services (CMS) that excludes patients whose physicians practice as part of health care teams that bill globally for their care, despite the fact that health care teams are essential to overcome the impact of severe physician shortages in medically underserved communities. The report also concludes that the rule has an equally serious impact on Medicare patients served by rural health clinics (RHCs).

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