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Tag Archive | "ACO"

CMS Announces New ACO Initiatives

Earlier this year, CMS release regulations on one of the signature health care reform proposals – the Accountable Care Organization. Perhaps to the Agency’s surprise, hospitals and physicians, who would be eligible to develop an ACO, have outlined numerous concerns with the proposal. Recognizing various concerns, on May 17, the CMS Center for Medicare and Medicaid Innovation announced three initiatives that would encourage doctors, hospitals, and other health care providers to become an Accountable Care Organization (ACO).

CMS is accepting applications for a Pioneer ACO Model, which is designed for organizations that already have an ACO or significant care coordination processes. The model is intended to work in conjunction with private payers to achieve cost savings and improve outcomes. Organizations interested in applying to the Pioneer ACO Model must submit a letter of intent on or before June 30, 2011. Applications must be received on or before August 19, 2011. In addition, the Agency requests comments on whether it should offer an Advanced Payment ACO Initiative that would allow certain ACOs participating in the Medicare Shared Savings Program access to a portion of their shared savings up front to help make the necessary investment critical to a successful ACO. Comments are due to CMS by June 17, 2011. Finally, CMS will host Accelerated Development Learning Sessions that will detail for providers the ways in which they can improve care delivery and develop an action plan for better coordinating care. The first of four learning sessions will be held in Minneapolis, Minnesota from June 20-22.

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CMS Releases FAQ Document Regarding ACOs

The Patient Protection and Affordable Care Act requires the Secretary to establish Accountable Care Organizations (ACOs), which will enable care coordinate among providers, by January 1, 2012. ACOs that meet quality targets and reduce the costs of their patients by coordinating items and services under Medicare Part A and Part B are rewarded with a share of the savings they achieve. Physician groups, hospitals, nurse practitioners and physician assistants, and others can participate in ACOs.

The Centers for Medicare and Medicaid Services (CMS) has relayed that while specific quality performance standards will be determined by the Secretary, ACOs will be measured on clinical processes and outcomes of care, patient experience, and utilization of services.

In a Frequently Asked Questions document, CMS stated that the Agency will host an Open Door Forum this summary and will post details of the session by June 11 on its website: http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp#TopOfPage.  A Notice of Proposed Rulemaking is expected to be released in the fall.

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NQF Seeks Comments on Partnership for Applying Measures to Improve Quality

The National Quality Forum (NQF) has requested public and member comments on its plan to establish a Partnership for Applying Measures to Improve Quality.  If the Secretary of Health and Human Services (HHS) assigns NQF with the responsibility to convene multi-stakeholder groups to provide input to the Secretary on the selection of new quality measures as required by the Patient Protection and Affordable Care Act, NQF will proceed with establishing the Partnership.

NQF envisions that the Partnership would provide input regarding Hospital Compare, the Physician Quality Reporting Initiative (PQRI), the hospital readmissions reduction program, the payment adjustment for hospital acquired conditions, measures for demonstrations (medical homes, accountable care organizations, bundled payments), and public reporting websites.

Any stakeholder who is interested in the quality provisions of the health reform law should take the opportunity to provide NQF with comments, which are due to NQF by June 15, 2010 at 6:00 pm Eastern Time.

 

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