Breaking Down Barriers to Creating Safety-Net Accountable Care Organizations: State Statutory and Regulatory Issues

Abstract

This report focuses on three major state law issues: tort liability, scope of practice, and the corporate practice of medicine doctrine. The authors argue that statutory and regulatory schemes need to be re-examined to ensure that Accountable Care Organizations (ACOs) can form. For example, lawmakers should ask, in an age when health care is changing dramatically in America, whether the corporate practice of medicine doctrine should be preserved. The authors offer California as an example of a state that, like many others, has taken tentative steps toward health care innovation but needs to act decisively to ensure that the promise of the Affordable Care Act is realized for all Americans. This paper makes policy recommendations about the steps that lawmakers should take to prime California’s health care system to fully embrace safety-net ACOs. It concludes with brief examinations of ACO formation strategies that have been implemented successfully in other states.

Keywords: Accountable Care Act, Accountable Care Organizations, ACO, Health care delivery, Corporate practice of medicine, Health care safety-net, Safety-net providers, Medicare Shared Savings Program

JEL Classification: H51, I11, I18, K23, K32