CMS Announces Two New ACO Initiatives
June 1, 2011 – On May 17, 2011, CMS’ Innovation Center released the following three (3) new initiatives under the Shared Savings Program designed to help physicians, hospitals and other health care providers to become accountable care organizations (ACOs).
Pioneer ACO Model
This model is designed for health care organizations and providers that are already experienced in coordinating care for patients across care settings. CMS wants to recruit providers to form up to 30 “Pioneer” ACOs that would begin operation this year. These provider groups would be allowed to move more rapidly from a shared savings payment model to a population-based payment model on a track consistent with, but separate from, the Medicare Shared Savings Program and allow them to work in coordination with private payers to achieve cost savings and improve quality access across the ACO.
The model will include protections for beneficiaries as provider participation is purely voluntary. Participating patients will see no change in benefits and will be able to see any provider. The aim is to promote accountability in highly experienced provider organizations for a population of Medicare beneficiaries by improving the coordination of care, encourage investment in infrastructure, reward higher value care and reduce the rate of growth in health care spending.
Interested groups must submit a letter of intent to the CMS by June 10 and officially apply by July 18.
The anticipated start date of this initiative would be in the third or fourth quarter of 2011 and the initial performance period would last until December 31, 2012, with subsequent renewal periods of 12 months. This is in contrast to the start date of January 1, 2012 and the three-year performance period of the Shared Savings ACO proposal for all other entities and providers interested in becoming or joining ACOs. The Pioneer ACO model also provides for a greater base-line of patients, 15,000 instead of the 5,000 in the draft regulations.
Click below to get more information on this program, and instructions on how to request an application and apply to the program.
Pioneer ACO Program
Advance Payment ACO
The second initiative allows for a comment period on the idea of an Advance Payment ACO model that would provide additional up-front funding to providers to encourage and support the formation of new ACOs. Under the proposed initiative, eligible organizations could receive an advance on the shared savings they are expected to earn as a monthly payment for each aligned Medicare beneficiary. ACOs would need to provide a plan for using these funds to build care coordination capabilities and meet other criteria. These advanced payments would be recouped through the ACO’s earned savings.
The Innovation Center is looking for reactions and suggestions from the public on this potential initiative which may be electronically submitted to “advpayACO@cms.hhs.gov.” Comments must be submitted by June 17, 2011.
For more information, click below.
Tags: Healthcare Reform
