== — PROMOTING PRIMARY CARE, MENTAL HEALTH SERVICES, AND COORDINATED CARE==
. Title XVIII of the Social Security Act is amended by inserting after section 1866C the following new section:
``(a) In general.—The Secretary shall conduct a pilot program (in this section referred to as the ‘pilot program’) to test different payment incentive models, including (to the extent practicable) the specific payment incentive models described in subsection (c), designed to reduce the growth of expenditures and improve health outcomes in the provision of items and services under this title to applicable beneficiaries (as defined in subsection (d)) by qualifying accountable care organizations (as defined in subsection (b)(1)) in order to— ``(1) promote accountability for a patient population and coordinate items and services under parts A and B;
``(2) encourage investment in infrastructure and redesigned care processes for high quality and efficient service delivery; and
``(3) reward physician practices and other physician organizational models for the provision of high quality and efficient health care services.
``(b) Qualifying Accountable care organizations (ACOs).—
``(1) Qualifying ACO defined.—In this section: ``(A) In general.—The terms ‘qualifying accountable care organization’ and ‘qualifying ACO’ mean a group of physicians or other physician organizational model (as defined in subparagraph (D)) that— ``(i) is organized at least in part for the purpose of providing physicians’ services; and
``(ii) meets such criteria as the Secretary determines to be appropriate to participate in the pilot program, including the criteria specified in paragraph (2).
``(B) Inclusion of other providers.—Nothing in this subsection shall be construed as preventing a qualifying ACO from including a hospital or any other provider of services or supplier furnishing items or services for which payment may be made under this title that is affiliated with the ACO under an arrangement structured so that such provider or supplier participates in the pilot program and shares in any incentive payments under the pilot program.
``(C) Physician.—The term ‘physician’ includes, except as the Secretary may otherwise provide, any individual who furnishes services for which payment may be made as physicians’ services.
``(D) Other physician organizational model.—The term ‘other physician organization model’ means, with respect to a qualifying ACO any model of organization under which physicians enter into agreements with other providers for the purposes of participation in the pilot program in order to provide high quality and efficient health care services and share in any incentive payments under such program.
``(E) Other services.—Nothing in this paragraph shall be construed as preventing a qualifying ACO from furnishing items or services, for which payment may not be made under this title, for purposes of achieving performance goals under the pilot program.
``(2) Qualifying criteria.—The following are criteria described in this paragraph for an organized group of physicians to be a qualifying ACO: ``(A) The group has a legal structure that would allow the group to receive and distribute incentive payments under this section.
``(B) The group includes a sufficient number of primary care physicians for the applicable beneficiaries for whose care the group is accountable (as determined by the Secretary).
``(C) The group reports on quality measures in such form, manner, and frequency as specified by the Secretary (which may be for the group, for providers of services and suppliers, or both).
``(D) The group reports to the Secretary (in a form, manner and frequency as specified by the Secretary) such data as the Secretary determines appropriate to monitor and evaluate the pilot program.
``(E) The group provides notice to applicable beneficiaries regarding the pilot program (as determined appropriate by the Secretary).
``(F) The group contributes to a best practices network or website, that shall be maintained by the Secretary for the purpose of sharing strategies on quality improvement, care coordination, and efficiency that the groups believe are effective.
``(G) The group utilizes patient-centered processes of care, including those that emphasize patient and caregiver involvement in planning and monitoring of ongoing care management plan.
``(H) The group meets other criteria determined to be appropriate by the Secretary.