Accountable Care News
27 New ACOs Forming Under the Medicare Shared Savings Program
April 13, 2012 - The Centers for Medicare & Medicaid Services (CMS) recently announced the selection of the first 27 accountable care organizations (ACOs) to participate in the Medicare Shared Savings Program (MSSP). Through better coordination and communication among healthcare providers, the selected organizations will be responsible for improving care for nearly 375,000 Medicare beneficiaries in eighteen states. All those that succeed in meeting the established quality performance measures while reducing the overall cost of care may share in the cost savings with Medicare. Those measures relate to improved care coordination and patient safety, providing appropriate preventive health services, improving care for at-risk populations, and enhancing the patient experience of care. Full Article
Kaiser Family Foundation Implementation Timeline
February 23, 2012 - Kaiser Family Foundation's Health Reform Source website provides a wealth of timely health reform information, including an "Implementation Timeline." The user-friendly interactive timeline explains how and when the provisions of the Affordable Care Act will be implemented over the next several years, including Accountable Care Organizations through Medicare. Full Article
Can Accountable-Care Organizations Improve Health Care While Reducing Costs?
January 23, 2012 - The Wall Street Journal asked a group of health-care policy experts to discuss whether accountable care organizations (ACOs) are an answer to problems of America's current health-care system, and published excerpts from those interviews in a recent article. The experts include: Donald M. Berwick, most recent former administrator of the Centers for Medicare and Medicaid Services, who oversaw the development of the CMS rules around ACOs; Tom Scully, former Center for Medicare and Medicaid Services administrator from 2001 to 2004; and Jeff Goldsmith, associate professor of public-health sciences at the University of Virginia, in Charlottesville. Full Article
Successes of the Affordable Care Act Includes Accountable Care Initiatives
January 20, 2012 - In a recent report, the Center for American Progress cited several successes of the Patient Protection and Affordable Care Act (ACA), also known as the Obamacare health reform law. Even though the full implementation of the law is a few years away, the report reviews how the ACA has to date increased by millions the number of Americans who are now getting coverage who didn't have insurance before; implemented protections against rate insurance hikes; created jobs and increased access to health care services through federally funded health care clinics; and improved health care affordability for patients. The report also highlights initiatives by the government to improve the quality of health care by expanding the primary care physician workforce; rewarding value in health care through the Pioneer Accountable Care Organization program and other forms of delivery system improvements; improving safety in hospitals through the Partnership for Patients; and providing home care services to Medicare beneficiaries through the Independence at Home demonstration projects. Full Article
CMS's Pioneer ACO Program Includes 21 AMGA Groups
December 22, 2011 - The American Medical Group Association (AMGA) announced that 21 of its members were among the 32 organizations chosen to participate in the Pioneer ACO Model initiative. The Pioneer ACO Model is a CMS Innovation Center initiative designed to support organizations with experience operating as Accountable Care Organizations (ACOs) or in similar arrangements in providing more coordinated care to beneficiaries at a lower cost to Medicare. The Pioneer ACO Model will test the impact of different payment arrangements in helping these organizations achieve the goals of providing better care to patients, and reducing Medicare costs. Full Article
Several CAPP Groups Selected to Participate as Pioneer ACOs
December 19, 2011 - Several multispecialty physician groups and physician-led health systems that are members of the Council of Accountable Physician Practices (CAPP), a subsidiary of the American Medical Group Association (AMGA), have been chosen to participate in the Pioneer Accountable Care Organization (ACO) program under the Centers for Medicare & Medicaid Services (CMS) Innovation Center (Innovation Center). An initiative of the Affordable Care Act, the Pioneer ACO initiative will encourage health care providers caregivers to deliver better, more coordinated care for Medicare beneficiaries, and, according to the U.S. Department of Health and Human Services, could save up to $1.1 billion over five years in American health care costs. Full Article
Austin Regional Clinic Medical Director Says Texas Can Improve Care, Cut Costs with Medical Home
November 28, 2011 - Austin Regional Clinic (ARC), a 300-physician multispecialty medical group, has embarked on a medical home pilot with Blue Cross and Blue Shield of Texas and the Texas Employees Retirement System (ERS). In his commentary written for Texas Family Physician, Dr. Gregg Scheff, the medical director for ARC's Medical Home Program, draws on his recent experience there to conclude that providing primary-care-driven, patient-focused, coordinated care is indeed possible in in a fee-for-service marketplace. However, he writes, there is a "definite tipping-point phenomenon in committing the resources necessary to develop adequate infrastructure to effectively and comprehensively manage patients’ well-being across the care spectrum." Full Article
NCQA Announces Accreditation Plans for ACOs
November 17, 2011 - In the accountable care world, value will be rewarded over volume. The question then becomes how to measure value in health care, i.e., quality for the cost. The National Committee for Quality Assurance (NCQA)--the widely recognized accreditation body for health plans and providers--has stepped up to develop quality standards not only for "medical homes," but for accountable care organizations. Their ACO Accreditation Program, launched this week, measures performance by health care providers across the "triple aim" of cost, quality and patient experience. Full Article
Commonwealth Fund Study: Health Care Leaders Support ACA
November 15, 2011 - The Commonwealth Fund/Modern Healthcare Survey reports that 9 of 10 health care and health policy leaders believe it is important for local and national policymakers to continue to implement the Affordable Care Act. Survey respondents think the growth in national health spending can be lowered without harming access to or quality of care and support implementation of insurance market changes, Medicaid expansion, and premium tax credits, as well as implement payment and delivery system initiatives such as the Center for Medicare and Medicaid Innovation, Patient-Centered Outcomes Research Institute, and Independent Payment Advisory Board. President Obama’s framework to reduce the federal budget deficit by building on the law and achieving further savings in Medicare and Medicaid were also supported by the majority of respondents. Full Article
New Urban Institute White Paper: Accountable Care Organizations in Medicare and the Private Sector: A Status Update
November 7, 2011 - A new white paper released by the Urban Institute's Robert Berenson, MD, provides a timely update on the status of accountable care organizations in the United States. "Accountable Care Organizations in Medicare and the Private Sector: A Status Update" supplies an overview of the history of accountable care organizations and the movement for payment for value; a glossary of payment terminology; a review of the PGP Demo project and its role and potential in the evolution of ACOs; a summary of provider concerns about the proposed Medicare Shared Savings Program regulations and how CMS addressed those concerns; and provides answers to questions about attribution, health disparities, and more. A good primer on the current state of ACOs. Full Article
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