In April 2011, the Obama administration's rules for Accountable Care Organizations (ACOs) under the Affordable Care Act were unsatisfactory to insurers, to say the least. Critics said the combination of risk, hefty quality reporting and upfront costs, coupled with little or no early-stage savings, would deter providers from applying to be part of the first class of ACOs to begin operating April 1, 2012.

Nearly seven months later, however, the final version of the rules have been sweetened, but whether conditions have improved enough to entice enough providers to apply remains to be seen.

Nick Manetto, Vice President, Faegre Baker Daniels Consulting, and Jason Kimpel, a partner in Faegre Baker Daniels' corporate group, published an article in the fourth-quarter issue of The DC Captive Insurance Newsletter.