CMS Announces 27 ACOs
NEW AFFORDABLE CARE ACT PROGRAM TO IMPROVE CARE, CONTROL MEDICARE COSTS, OFF TO A STRONG START 
OVER 1.1 MILLION BENEFICIARIES NOW SERVED BY ACCOUNTABLE CARE ORGANIZATIONS

A new program that will help physicians, hospitals, and other health care providers work together to improve care for people with Medicare is off to a strong start, the Centers for Medicare & Medicaid Services (CMS) announced April 10.

Under the new Medicare Shared Savings Program (Shared Savings Program), 27 Accountable Care Organizations (ACOs) have entered into agreements with CMS, taking responsibility for the quality of care furnished to people with Medicare in return for the opportunity to share in savings realized through improved care. The Shared Savings Program and other initiatives related to Accountable Care Organizations are made possible by the Affordable Care Act, the healthcare law of 2010. Participation in an ACO is purely voluntary for providers and beneficiaries and people with Medicare retain their current ability to seek treatment from any provider they wish.


The first 27 Shared Savings Program ACOs will serve an estimated 375,000 beneficiaries in 18 states. This brings the total number of organizations participating Medicare shared savings initiatives on April 1 to 65, including the 32 Pioneer Model ACOs that were announced last December, and six Physician Group Practice Transition Demonstration organizations that started in January 2011.  In all, as of April 1, more than 1.1 million beneficiaries are receiving care from providers participating in Medicare shared savings initiatives.

"We are encouraged by this strong start and confident that by the end of this year, we will have a robust program in place, benefitting millions of seniors and people with disabilities across the country," said CMS Acting Administrator Marilyn Tavenner.

Anyone who has multiple doctors may have experienced the frustration of fragmented and disconnected care: lost or unavailable medical charts, trouble scheduling an appointment or talking to a doctor, duplicated medical procedures, or having to share the same information over and over with different doctors.

Accountable Care Organizations are designed to lift this burden from patients, while improving care and reducing costs. The Shared Savings Program was created by the Affordable Care Act after a number of efforts in the private sector showed that improving care can lead to lower costs.  The selected ACOs include more than 10,000 physicians, 10 hospitals, and 13 smaller physician-driven organizations in both urban and rural areas. Their models for coordinating care and improving quality vary in response to the needs of the beneficiaries in the areas they are serving. CMS is reviewing more than 150 applications from ACOs seeking to enter the program in July.

To ensure that savings are achieved through improving and providing care that is appropriate, safe, and timely, an ACO must meet strict quality standards.  For 2012, CMS has established 33 quality measures relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and the patient and caregiver experience of care.

CMS also announced five ACOs are participating in the Advance Payment ACO Model beginning April 1. This model will provide advance payment of expected shared savings to rural and physician-based ACOs participating in the Shared Savings Program that would benefit from additional start-up resources. These resources will help build the necessary care coordination infrastructure necessary to improve patient outcomes and reduce costs, such as new staff or information technology systems. CMS is reviewing more than 50 applications for Advance Payments that start in July.

To learn more about the ACOs announced April 10, visit: http://www.cms.gov/apps/media/fact_sheets.asp.

For more information on the Advanced Payment ACO Model, including the participating ACOs, visit:http://innovations.cms.gov/initiatives/ACO/Advance-Payment/.

 

AMA Pleased That Majority of New ACOs Will Be Physician-Led

Statement By:        
Peter W. Carmel, MD
President, American Medical Association

“We are extremely pleased that a majority of the 27 newest Medicare Accountable Care Organizations (ACOs) announced today by CMS will be physician-led and five of the new groups will participate in the advanced payment model. The AMA strongly advocated for these two options, and today’s CMS announcement shows that allowing all interested physicians to lead and participate in this new model increases the number of groups forming Medicare ACOs.

“Physician practices are benefiting from the financial assistance offered by the advanced payment initiative, which was created as a direct result of the AMA’s recommendation to CMS. The upfront payments offered through this program help with the cost of starting an ACO, which is especially beneficial for small physician practices.

“Allowing physicians in all practice settings and sizes to participate increases the number of Medicare ACOs and maximizes the benefits for patients, physicians, taxpayers and the Medicare system as a whole. CMS’ announcement today shows that many of the first ACOs will be lead by physicians and build on existing physician-patient relationships. This is critical to successfully improve the quality of patient care while reducing costs. While not all physicians will choose to be part of an ACO, allowing all who are interested to participate in this new model helps its prospects for long-term success.

“The AMA offers interested physicians resources to help them form an ACO, including a webinarwhite papervideo and 'how-to' manual.”

 
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