CMS announces three new ACO initiatives

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Financial outlook is grim for not-for-profits, analyst says
Financial outlook is grim for not-for-profits, analyst says

The Centers for Medicare & Medicaid Services on Tuesday announced three new ideas to drive interest among healthcare providers for forming an accountable care organization. Agency officials were responding, in part, to a wave of criticism over the potential costs of an ACO start-up.

ACOs, which are scheduled to launch on Jan. 1, 2012, were created under the Affordable Care Act in an attempt to change the way programs such as Medicare reimburses healthcare providers. The ACO model lets providers keep a percentage of the money paid by Medicare when they collaborate to provide care. Some big providers, such as the Mayo Clinic, have said that high costs would preclude their participation.

In response, CMS has proposed three new initiatives that it hopes will encourage physicians, hospitals and other healthcare providers — including long-term care facilities — to work together. The initiatives will be run by the newly created Center for Medicare and Medicaid Innovation, which is a byproduct of the Affordable Care Act

The Pioneer ACO Model is targeted to organizations that have already begun coordinating patients, allowing providers to move more rapidly from a shared savings payment model to a population-based payment model consistent with, but separate from, the Medicare Shared Savings Program. The Advanced Payment ACO would let certain providers get their expected savings up front as an incentive to invest in care coordination. The third initiative, Accelerated Development Learning Sessions would help educate providers on ways to improve delivery and coordination.

“We are conscious of the fact that an ACO has to be an attractive model,” said Jonathan Blum, deputy administrator and director of CMS. “We want to create incentives.”

The public is invited to comment on the Medicare Shared Savings Program until June 6, and on the Advance Payment ACO model until June 17, at www.regulations.gov.
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