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Nursing Facilities Can Be Included in New ACOs  
Nursing Facilities Can Be Included in New ACOs
Katherine Lehman

Washington, DC – Post-acute care facilities – including nursing homes – would be eligible to participate in new Accountable Care Organizations (ACOs) as soon as quality measures for care are finalized in these settings, finds an initial analysis by the American Health Care Association (AHCA). The analysis examines the proposed rule on establishing ACOs issued by the Centers for Medicare & Medicaid Services (CMS) last week. 

“We are pleased that CMS carefully considered and accepted AHCA’s recommendation to include skilled nursing facilities and other post-acute care providers on its list of ACO-eligible providers. Our membership and other post-acute care providers are adept in coordinating patients’ care by working with physicians, hospitals and other key stakeholders. Skilled nursing facilities will be an asset to new ACOs as we aim to build a higher-quality, more cost-effective experience for those needing care,” commented Governor Mark Parkinson, President and CEO of AHCA.  

AHCA’s analysis of the proposed rule determined that the Secretary of Health and Human Services has the ability to include post acute care facilities, which “will enable ACOs to offer more comprehensive care and better serve the needs of rural communities.”[1] CMS also proposes using quality measures for the first year, and then adding measures for hospital-based care and for other settings, including nursing homes, to expand the ACO, concluded AHCA.  

Meanwhile, CMS is soliciting comments regarding the types of providers and suppliers that should be included as potential ACO participants, as well as their potential benefits or concerns during its 60-day comment period on the proposed rule. AHCA will provide comments to CMS before the comment period ends on June 6, 2011. 


In subsequent program years through additional rulemaking, we would expect to refine and expand the ACO measures to enhance our ability to assess the quality of care furnished by ACOs participating in the Shared Savings Program and expand measures reporting mechanisms to include those that are directly EHR-based. Specifically, we expect to expand the measures through future rulemaking to include other highly prevalent conditions and areas of interest, such as frailty, as well as measures of caregiver experience. In addition to ambulatory measures, we would expect to add measures of hospital-based care and quality measures for care furnished in other settings, such as home health services and nursing homes.[2]

The proposed rule has been placed on display, and is expected to be published in the Federal Register on April 7, 2011.

[1] CMS-1345-P. pg. 49
[2] CMS-1345-P. pg. 195

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represent more than 13,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and developmental disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit or