Mary Ellen Schneider

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren’t just a new way to pay for care; they’re a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn’t know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren’t just a new way to pay for care; they’re a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn’t know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren’t just a new way to pay for care; they’re a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn’t know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren’t just a new way to pay for care; they’re a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn’t know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren’t just a new way to pay for care; they’re a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn’t know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren’t just a new way to pay for care; they’re a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn’t know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren’t just a new way to pay for care; they’re a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn’t know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren’t just a new way to pay for care; they’re a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn’t know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren’t just a new way to pay for care; they’re a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn’t know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren't just a new way to pay for care; they're a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn't know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren't just a new way to pay for care; they're a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn't know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

After months of deliberation, officials at the Centers for Medicare and Medicaid Services released on March 31 a proposed rule outlining how physicians, hospitals, and long-term care facilities can work together to form accountable care organizations and share in the savings they achieve for Medicare.

The voluntary program was created under the Affordable Care Act and will begin in Jan. 2012. Under the proposal, accountable care organizations (ACOs) could include physicians in group practice, networks of individual practices, hospitals that employ physicians, and partnerships among these entities, as well as other providers. The idea is for ACOs to be a partnership among a range of physicians, including specialists and primary care providers. However, only primary care providers will be able to form an ACO, according to CMS.

According to the proposed rule, providers in the ACO would continue to receive their regular fee-for-service payments under Medicare, but they could also qualify for additional payment if their care resulted in savings to the program. The proposed framework requires that ACOs meet certain quality standards and demonstrate that they have reduced costs in order to be eligible to share in any savings. The proposal outlines 65 quality measures in five quality domains: patient experience, care coordination, patient safety, preventive health, and care of at-risk and frail elderly populations.

"ACOs aren't just a new way to pay for care; they're a new model for the organization and delivery of the care under Medicare," Dr. Donald Berwick, CMS administrator, said during a press conference to announce the proposed rule.

Dr. Berwick said he doesn't know how many ACOs will form under the program, but that the level of interest is "enormous."

Since the Affordable Care Act was passed last year, the health care community has been buzzing about how ACOs might be structured and if they could succeed in reducing health care costs. Integrated care organizations like Geisinger Health System in Danville, Pa., are considered to have a leg up because their hospital and outpatient care is already coordinated.

But Dr. Berwick said that the proposal allows for ACOs at various levels of development to participate. For example, less developed ACOs can choose to receive only shared savings for 2 years before assuming risk. More mature organizations can assume risk immediately but be eligible for greater levels of shared savings. "Our aim is to create on-ramps that will allow many to participate, depending on the different levels of maturity they are starting with," Dr. Berwick said.

CMS officials estimate that the program could result in as much as $960 million in Medicare savings over 3 years.

Although federal officials said that they expect the coordinated care to pay dividends in savings to Medicare, ACOs will not be set up like HMOs. Medicare beneficiaries will continue to be able to see their choice of providers under fee-for-service Medicare. Providers will be the ones that enroll in ACOs and must notify patients that they are receiving care within an ACO.

In addition to the ACO proposed rule, the Department of Justice and the Federal Trade Commission have also issued guidance on how physicians and hospitals that form an ACO can steer clear of antitrust laws. Officials at the CMS and the Office of the Inspector General have also issued a notice on potential waivers that could be granted in connection with the shared savings program, and the Internal Revenue Service has issued new guidance for tax-exempt hospitals seeking to participate in the program.

The CMS will be accepting comments on the proposed rule for 60 days. The agency also plans a series of open-door forums and listening sessions to explain the proposal and to get feedback from the public.

At press time, the American Medical Association said that it was reviewing the proposed rule and the policy statements from the Federal Trade Commission and the Department of Justice. In a statement, Dr. Jeremy A. Lazarus, the speaker of the AMA House of Delegates, said that ACOs offer "great promise" but that there are still a number of barriers to success, including the large capital requirements to fund an ACO and to make the necessary changes to individual physician practices.

Female Pelvic Medicine and Reconstructive Surgery is now an official subspecialty of both obstetrics and gynecology and urology.

The American Board of Medical Specialties in March announced that it has granted subspecialty status to this growing area of urogynecology. The new subspecialty will be jointly boarded through the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology (ABU).

Leaders in urogynecology have been laying the groundwork for this recognition for the last 15 years, said Dr. Dee E. Fenner, director of the ABU and ABOG Subspecialty Board for Female Pelvic Medicine and Reconstructive Surgery and director of benign gynecology at the University of Michigan in Ann Arbor. Officials at the ABU and the ABOG began by developing program requirements and criteria to begin accrediting fellowship programs in female pelvic medicine and reconstructive surgery. Today, there are 43 fellowship programs that have been accredited by these bodies, Dr. Fenner said in an interview. That robust level of training, plus the needs of the aging population are both reasons to proceed with subspecialty recognition.

In addition to the recognition of the subspecialty by ABMS, the American Council for Graduate Medical Education (ACGME) will now take over accreditation for fellowship programs in the specialty.

The ABOG and ABU are currently preparing for both a written and oral exam for the new subspecialty, and the first exams are likely to take place in 2013, Dr. Fenner said. Physicians who are currently working in the field will be able to apply for "grandfather" status for the next few years. However, residents graduating this year must complete a fellowship in female pelvic medicine and reconstructive surgery in order to be eligible to sit for the exam. Dr. Fenner said she anticipates that about 750 physicians, both gynecologists and urologists, who are currently practicing will seek certification in the new subspecialty.

"We need a lot of people because the demands are great for this subspecialty," said Dr. Cheryl Iglesia, a urogynecologist at Georgetown University in Washington, D.C., who serves as the chair of the committee for gynecologic practice at the American Congress of Obstetricians and Gynecologists (ACOG) and sits on the board of directors for the American Urogynecologic Society (AUGS).

Dr. Iglesia said there is a growing need to train more physicians who can provide these types of services to the aging baby boomers. Over the next few decades, the demand will jump dramatically, she said in an interview. In addition, there is an increasing level of clinical and basic research going on in the field that requires more physicians with advanced training.

As a result of recognition by both the accrediting and certifying bodies, patients will have the assurance that physicians who are board certified in female pelvic medicine have completed advanced training, Dr. Fenner said. General ob.gyns. also will know what they are getting when they refer complex cases to subspecialists.

Female Pelvic Medicine and Reconstructive Surgery is now an official subspecialty of both obstetrics and gynecology and urology.

The American Board of Medical Specialties in March announced that it has granted subspecialty status to this growing area of urogynecology. The new subspecialty will be jointly boarded through the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology (ABU).

Leaders in urogynecology have been laying the groundwork for this recognition for the last 15 years, said Dr. Dee E. Fenner, director of the ABU and ABOG Subspecialty Board for Female Pelvic Medicine and Reconstructive Surgery and director of benign gynecology at the University of Michigan in Ann Arbor. Officials at the ABU and the ABOG began by developing program requirements and criteria to begin accrediting fellowship programs in female pelvic medicine and reconstructive surgery. Today, there are 43 fellowship programs that have been accredited by these bodies, Dr. Fenner said in an interview. That robust level of training, plus the needs of the aging population are both reasons to proceed with subspecialty recognition.

In addition to the recognition of the subspecialty by ABMS, the American Council for Graduate Medical Education (ACGME) will now take over accreditation for fellowship programs in the specialty.

The ABOG and ABU are currently preparing for both a written and oral exam for the new subspecialty, and the first exams are likely to take place in 2013, Dr. Fenner said. Physicians who are currently working in the field will be able to apply for "grandfather" status for the next few years. However, residents graduating this year must complete a fellowship in female pelvic medicine and reconstructive surgery in order to be eligible to sit for the exam. Dr. Fenner said she anticipates that about 750 physicians, both gynecologists and urologists, who are currently practicing will seek certification in the new subspecialty.

"We need a lot of people because the demands are great for this subspecialty," said Dr. Cheryl Iglesia, a urogynecologist at Georgetown University in Washington, D.C., who serves as the chair of the committee for gynecologic practice at the American Congress of Obstetricians and Gynecologists (ACOG) and sits on the board of directors for the American Urogynecologic Society (AUGS).

Dr. Iglesia said there is a growing need to train more physicians who can provide these types of services to the aging baby boomers. Over the next few decades, the demand will jump dramatically, she said in an interview. In addition, there is an increasing level of clinical and basic research going on in the field that requires more physicians with advanced training.

As a result of recognition by both the accrediting and certifying bodies, patients will have the assurance that physicians who are board certified in female pelvic medicine have completed advanced training, Dr. Fenner said. General ob.gyns. also will know what they are getting when they refer complex cases to subspecialists.

Female Pelvic Medicine and Reconstructive Surgery is now an official subspecialty of both obstetrics and gynecology and urology.

The American Board of Medical Specialties in March announced that it has granted subspecialty status to this growing area of urogynecology. The new subspecialty will be jointly boarded through the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology (ABU).

Leaders in urogynecology have been laying the groundwork for this recognition for the last 15 years, said Dr. Dee E. Fenner, director of the ABU and ABOG Subspecialty Board for Female Pelvic Medicine and Reconstructive Surgery and director of benign gynecology at the University of Michigan in Ann Arbor. Officials at the ABU and the ABOG began by developing program requirements and criteria to begin accrediting fellowship programs in female pelvic medicine and reconstructive surgery. Today, there are 43 fellowship programs that have been accredited by these bodies, Dr. Fenner said in an interview. That robust level of training, plus the needs of the aging population are both reasons to proceed with subspecialty recognition.

In addition to the recognition of the subspecialty by ABMS, the American Council for Graduate Medical Education (ACGME) will now take over accreditation for fellowship programs in the specialty.

The ABOG and ABU are currently preparing for both a written and oral exam for the new subspecialty, and the first exams are likely to take place in 2013, Dr. Fenner said. Physicians who are currently working in the field will be able to apply for "grandfather" status for the next few years. However, residents graduating this year must complete a fellowship in female pelvic medicine and reconstructive surgery in order to be eligible to sit for the exam. Dr. Fenner said she anticipates that about 750 physicians, both gynecologists and urologists, who are currently practicing will seek certification in the new subspecialty.

"We need a lot of people because the demands are great for this subspecialty," said Dr. Cheryl Iglesia, a urogynecologist at Georgetown University in Washington, D.C., who serves as the chair of the committee for gynecologic practice at the American Congress of Obstetricians and Gynecologists (ACOG) and sits on the board of directors for the American Urogynecologic Society (AUGS).

Dr. Iglesia said there is a growing need to train more physicians who can provide these types of services to the aging baby boomers. Over the next few decades, the demand will jump dramatically, she said in an interview. In addition, there is an increasing level of clinical and basic research going on in the field that requires more physicians with advanced training.

As a result of recognition by both the accrediting and certifying bodies, patients will have the assurance that physicians who are board certified in female pelvic medicine have completed advanced training, Dr. Fenner said. General ob.gyns. also will know what they are getting when they refer complex cases to subspecialists.

Female Pelvic Medicine and Reconstructive Surgery is now an official subspecialty of both obstetrics and gynecology and urology.

The American Board of Medical Specialties in March announced that it has granted subspecialty status to this growing area of urogynecology. The new subspecialty will be jointly boarded through the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology (ABU).

Leaders in urogynecology have been laying the groundwork for this recognition for the last 15 years, said Dr. Dee E. Fenner, director of the ABU and ABOG Subspecialty Board for Female Pelvic Medicine and Reconstructive Surgery and director of benign gynecology at the University of Michigan in Ann Arbor. Officials at the ABU and the ABOG began by developing program requirements and criteria to begin accrediting fellowship programs in female pelvic medicine and reconstructive surgery. Today, there are 43 fellowship programs that have been accredited by these bodies, Dr. Fenner said in an interview. That robust level of training, plus the needs of the aging population are both reasons to proceed with subspecialty recognition.

In addition to the recognition of the subspecialty by ABMS, the American Council for Graduate Medical Education (ACGME) will now take over accreditation for fellowship programs in the specialty.

The ABOG and ABU are currently preparing for both a written and oral exam for the new subspecialty, and the first exams are likely to take place in 2013, Dr. Fenner said. Physicians who are currently working in the field will be able to apply for "grandfather" status for the next few years. However, residents graduating this year must complete a fellowship in female pelvic medicine and reconstructive surgery in order to be eligible to sit for the exam. Dr. Fenner said she anticipates that about 750 physicians, both gynecologists and urologists, who are currently practicing will seek certification in the new subspecialty.

"We need a lot of people because the demands are great for this subspecialty," said Dr. Cheryl Iglesia, a urogynecologist at Georgetown University in Washington, D.C., who serves as the chair of the committee for gynecologic practice at the American Congress of Obstetricians and Gynecologists (ACOG) and sits on the board of directors for the American Urogynecologic Society (AUGS).

Dr. Iglesia said there is a growing need to train more physicians who can provide these types of services to the aging baby boomers. Over the next few decades, the demand will jump dramatically, she said in an interview. In addition, there is an increasing level of clinical and basic research going on in the field that requires more physicians with advanced training.

As a result of recognition by both the accrediting and certifying bodies, patients will have the assurance that physicians who are board certified in female pelvic medicine have completed advanced training, Dr. Fenner said. General ob.gyns. also will know what they are getting when they refer complex cases to subspecialists.

Female Pelvic Medicine and Reconstructive Surgery is now an official subspecialty of both obstetrics and gynecology and urology.

The American Board of Medical Specialties in March announced that it has granted subspecialty status to this growing area of urogynecology. The new subspecialty will be jointly boarded through the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology (ABU).

Leaders in urogynecology have been laying the groundwork for this recognition for the last 15 years, said Dr. Dee E. Fenner, director of the ABU and ABOG Subspecialty Board for Female Pelvic Medicine and Reconstructive Surgery and director of benign gynecology at the University of Michigan in Ann Arbor. Officials at the ABU and the ABOG began by developing program requirements and criteria to begin accrediting fellowship programs in female pelvic medicine and reconstructive surgery. Today, there are 43 fellowship programs that have been accredited by these bodies, Dr. Fenner said in an interview. That robust level of training, plus the needs of the aging population are both reasons to proceed with subspecialty recognition.

In addition to the recognition of the subspecialty by ABMS, the American Council for Graduate Medical Education (ACGME) will now take over accreditation for fellowship programs in the specialty.

The ABOG and ABU are currently preparing for both a written and oral exam for the new subspecialty, and the first exams are likely to take place in 2013, Dr. Fenner said. Physicians who are currently working in the field will be able to apply for "grandfather" status for the next few years. However, residents graduating this year must complete a fellowship in female pelvic medicine and reconstructive surgery in order to be eligible to sit for the exam. Dr. Fenner said she anticipates that about 750 physicians, both gynecologists and urologists, who are currently practicing will seek certification in the new subspecialty.

"We need a lot of people because the demands are great for this subspecialty," said Dr. Cheryl Iglesia, a urogynecologist at Georgetown University in Washington, D.C., who serves as the chair of the committee for gynecologic practice at the American Congress of Obstetricians and Gynecologists (ACOG) and sits on the board of directors for the American Urogynecologic Society (AUGS).

Dr. Iglesia said there is a growing need to train more physicians who can provide these types of services to the aging baby boomers. Over the next few decades, the demand will jump dramatically, she said in an interview. In addition, there is an increasing level of clinical and basic research going on in the field that requires more physicians with advanced training.

As a result of recognition by both the accrediting and certifying bodies, patients will have the assurance that physicians who are board certified in female pelvic medicine have completed advanced training, Dr. Fenner said. General ob.gyns. also will know what they are getting when they refer complex cases to subspecialists.

Female Pelvic Medicine and Reconstructive Surgery is now an official subspecialty of both obstetrics and gynecology and urology.

The American Board of Medical Specialties in March announced that it has granted subspecialty status to this growing area of urogynecology. The new subspecialty will be jointly boarded through the American Board of Obstetrics and Gynecology (ABOG) and the American Board of Urology (ABU).

Leaders in urogynecology have been laying the groundwork for this recognition for the last 15 years, said Dr. Dee E. Fenner, director of the ABU and ABOG Subspecialty Board for Female Pelvic Medicine and Reconstructive Surgery and director of benign gynecology at the University of Michigan in Ann Arbor. Officials at the ABU and the ABOG began by developing program requirements and criteria to begin accrediting fellowship programs in female pelvic medicine and reconstructive surgery. Today, there are 43 fellowship programs that have been accredited by these bodies, Dr. Fenner said in an interview. That robust level of training, plus the needs of the aging population are both reasons to proceed with subspecialty recognition.

In addition to the recognition of the subspecialty by ABMS, the American Council for Graduate Medical Education (ACGME) will now take over accreditation for fellowship programs in the specialty.

The ABOG and ABU are currently preparing for both a written and oral exam for the new subspecialty, and the first exams are likely to take place in 2013, Dr. Fenner said. Physicians who are currently working in the field will be able to apply for "grandfather" status for the next few years. However, residents graduating this year must complete a fellowship in female pelvic medicine and reconstructive surgery in order to be eligible to sit for the exam. Dr. Fenner said she anticipates that about 750 physicians, both gynecologists and urologists, who are currently practicing will seek certification in the new subspecialty.

"We need a lot of people because the demands are great for this subspecialty," said Dr. Cheryl Iglesia, a urogynecologist at Georgetown University in Washington, D.C., who serves as the chair of the committee for gynecologic practice at the American Congress of Obstetricians and Gynecologists (ACOG) and sits on the board of directors for the American Urogynecologic Society (AUGS).

Dr. Iglesia said there is a growing need to train more physicians who can provide these types of services to the aging baby boomers. Over the next few decades, the demand will jump dramatically, she said in an interview. In addition, there is an increasing level of clinical and basic research going on in the field that requires more physicians with advanced training.

As a result of recognition by both the accrediting and certifying bodies, patients will have the assurance that physicians who are board certified in female pelvic medicine have completed advanced training, Dr. Fenner said. General ob.gyns. also will know what they are getting when they refer complex cases to subspecialists.

The number of U.S. medical students who chose residencies in psychiatry this year fell slightly, according to this year’s National Resident Matching Program.

Overall, 1,097 psychiatry positions were offered in 2011. Of those, 97.4% were filled, with 58.3% of the slots being taken by U.S. medical graduates. Last year, 61.4% of the 1,091 positioned offered were filled by U.S. medical graduates. Over the last five years, the fill rate among U.S. medical school seniors has gone up and down, with a low of 55.7% in 2008 and a high of 61.7% in 2009.

Similar declines were seen in some of the smaller psychiatry residency programs. For example, the medicine-psychiatry residency, which offered 19 positions this year, filled only 9 of them with U.S. medical graduates. In 2010, that category had 26 positions and 18 of them were filled by U.S. medical graduates. The peds/psych/child psychiatry residency program offered 19 positions this year and 12 were filled by U.S. medical graduates. Last year, that program offered 17 total positions and 15 were filled by U.S. medical graduates. The psychiatry-family medicine program filled all 9 of their total slots with U.S. medical graduates this year. In 2010, the program offered 13 slots and 10 were filled by U.S. medical graduates.

Meanwhile, more U.S. medical students selected primary care.

The number of U.S. medical school seniors choosing family medicine rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

More U.S. medical school seniors also matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely attributable to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students might be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Neurology, emergency medicine, and anesthesiology also proved more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

The number of U.S. medical students who chose residencies in psychiatry this year fell slightly, according to this year’s National Resident Matching Program.

Overall, 1,097 psychiatry positions were offered in 2011. Of those, 97.4% were filled, with 58.3% of the slots being taken by U.S. medical graduates. Last year, 61.4% of the 1,091 positioned offered were filled by U.S. medical graduates. Over the last five years, the fill rate among U.S. medical school seniors has gone up and down, with a low of 55.7% in 2008 and a high of 61.7% in 2009.

Similar declines were seen in some of the smaller psychiatry residency programs. For example, the medicine-psychiatry residency, which offered 19 positions this year, filled only 9 of them with U.S. medical graduates. In 2010, that category had 26 positions and 18 of them were filled by U.S. medical graduates. The peds/psych/child psychiatry residency program offered 19 positions this year and 12 were filled by U.S. medical graduates. Last year, that program offered 17 total positions and 15 were filled by U.S. medical graduates. The psychiatry-family medicine program filled all 9 of their total slots with U.S. medical graduates this year. In 2010, the program offered 13 slots and 10 were filled by U.S. medical graduates.

Meanwhile, more U.S. medical students selected primary care.

The number of U.S. medical school seniors choosing family medicine rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

More U.S. medical school seniors also matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely attributable to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students might be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Neurology, emergency medicine, and anesthesiology also proved more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

The number of U.S. medical students who chose residencies in psychiatry this year fell slightly, according to this year’s National Resident Matching Program.

Overall, 1,097 psychiatry positions were offered in 2011. Of those, 97.4% were filled, with 58.3% of the slots being taken by U.S. medical graduates. Last year, 61.4% of the 1,091 positioned offered were filled by U.S. medical graduates. Over the last five years, the fill rate among U.S. medical school seniors has gone up and down, with a low of 55.7% in 2008 and a high of 61.7% in 2009.

Similar declines were seen in some of the smaller psychiatry residency programs. For example, the medicine-psychiatry residency, which offered 19 positions this year, filled only 9 of them with U.S. medical graduates. In 2010, that category had 26 positions and 18 of them were filled by U.S. medical graduates. The peds/psych/child psychiatry residency program offered 19 positions this year and 12 were filled by U.S. medical graduates. Last year, that program offered 17 total positions and 15 were filled by U.S. medical graduates. The psychiatry-family medicine program filled all 9 of their total slots with U.S. medical graduates this year. In 2010, the program offered 13 slots and 10 were filled by U.S. medical graduates.

Meanwhile, more U.S. medical students selected primary care.

The number of U.S. medical school seniors choosing family medicine rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

More U.S. medical school seniors also matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely attributable to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students might be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Neurology, emergency medicine, and anesthesiology also proved more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

For the second year in a row, more U.S. medical students are choosing careers in primary care, according to this year’s National Residency Matching Program data.

The number of U.S. medical school seniors choosing family medicine rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

More U.S. medical school seniors also matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely due to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students may be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Emergency medicine, anesthesiology, and neurology were also more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

For the second year in a row, more U.S. medical students are choosing careers in primary care, according to this year’s National Residency Matching Program data.

The number of U.S. medical school seniors choosing family medicine rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

More U.S. medical school seniors also matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely due to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students may be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Emergency medicine, anesthesiology, and neurology were also more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

For the second year in a row, more U.S. medical students are choosing careers in primary care, according to this year’s National Residency Matching Program data.

The number of U.S. medical school seniors choosing family medicine rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

More U.S. medical school seniors also matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely due to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students may be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Emergency medicine, anesthesiology, and neurology were also more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

For the second year in a row, more U.S. medical students are choosing careers in primary care, according to this year’s National Residency Matching Program data.

The number of U.S. medical school seniors choosing family medicine rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

More U.S. medical school seniors also matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely due to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students may be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Emergency medicine, anesthesiology, and neurology were also more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

For the second year in a row, more U.S. medical students are choosing careers in primary care, according to this year’s National Residency Matching Program data.

The number of U.S. medical school seniors choosing family medicine rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

More U.S. medical school seniors also matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely due to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students may be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Emergency medicine, anesthesiology, and neurology were also more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

For the second year in a row, more U.S. medical students are choosing careers in primary care, according to this year’s National Residency Matching Program data.

The number of U.S. medical school seniors choosing family medicine rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

More U.S. medical school seniors also matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely due to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students may be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Emergency medicine, anesthesiology, and neurology were also more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

For the second year in a row, more U.S. medical students are choosing careers in primary care, according to this year’s National Residency Matching Program data.

More U.S. medical school seniors matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

The number of U.S. medical school seniors choosing family medicine also rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely due to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students may be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Emergency medicine, anesthesiology, and neurology were also more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

For the second year in a row, more U.S. medical students are choosing careers in primary care, according to this year’s National Residency Matching Program data.

More U.S. medical school seniors matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

The number of U.S. medical school seniors choosing family medicine also rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely due to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students may be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Emergency medicine, anesthesiology, and neurology were also more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.

For the second year in a row, more U.S. medical students are choosing careers in primary care, according to this year’s National Residency Matching Program data.

More U.S. medical school seniors matched to internal medicine residencies, with the overall fill rate remaining roughly the same as in 2010. Overall, 5,121 internal medicine positions were offered in 2011. Of those, 98.9% were filled, with 57.4% of the slots being taken by U.S. medical graduates. In 2010, 54.5% of the 4,999 positions offered were filled by U.S. medical graduates.

The number of U.S. medical school seniors choosing family medicine also rose by 11% over last year. Overall, 2,708 family medicine residency positions were offered this year. Of those, 94.4% were filled, with 48% filled by U.S. medical graduates. This is the highest ever overall fill rate for the specialty, according to the American Academy of Family Physicians.

In pediatrics, interest by U.S. medical students rose about 3% from 2010. This year, 98.2% of the total 2,482 positions offered were filled. U.S. medical graduates filled 71.2% of the pediatric positions in 2011.

Leaders in primary care said the growing interest by medical students is likely due to the increased attention to primary care and the importance being placed on it, in part due to last year’s passage of the Affordable Care Act.

Dr. Steven E. Weinberger, executive vice president and CEO of the American College of Physicians, said students may be drawn to the idea of coordinating care and being the principal source of care for patients.

"Whenever an area of health careers is more important to the future, it’s going to resonate with student choice," said Dr. Roland A. Goertz, president of the American Academy of Family Physicians.

Emergency medicine, anesthesiology, and neurology were also more popular among U.S. medical graduates in this year’s match. For example, of the 266 PGY-1 positions offered in neurology in 2011, 59.8% went to U.S. medical graduates. This is up from 49.6% last year, when 228 positions were offered.

This year’s residency match offered more first- and second-year positions than in 2010. Overall, there were 638 more residency slots available. Of the first-year positions offered, more than 95% were filled.