Health Information Management

News: Comment period for ACOs closes

CDI Strategies, December 9, 2010

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CMS sought comments from healthcare providers regarding proposed implementation of accountable care organizations (ACOs). ACOs are a collaboration of various providers who work together to manage and coordinate care for Medicare beneficiaries and, in return, may receive payments for shared savings. 

In its initial request for comments, CMS posed several questions to help facilitate the creation of ACO implementation guidelines. They asked:
  • How should we assess beneficiary and caregiver experience of care as part of our assessment of ACO performance?
  • In order for an ACO to share in savings under the Medicare Shared Savings Program, it must meet a quality performance standard determined by the Secretary. What quality measures should the Secretary use to determine performance in the Shared Savings Program?
  • What additional payment models should CMS consider?
  • What are the relative advantages and disadvantages of any such alternative payment models?
The comment period ended on December 3.
 
“If structured carefully,” wrote MedPAC in its official comment to CMS, “a shared savings program for ACOs could present an opportunity to correct some of the undesirable incentives inherent in fee-for-service payment and reward providers who are doing their part to control costs and improve quality.”
MedPAC indicated implementation of ACOs could:
  • allow providers to share risk with Medicare for cost growth for their patients
  • help beneficiaries receive more coordinated care
  • help beneficiaries become more engaged with their care management, particularly if beneficiaries are informed when they are assigned to ACOs
 
However, MedPAC indicated that a number of concerns would need to be addressed by legislators in order for the ACOs to be successful such as “clear management and leadership structure and clear arrangements” to ensure the continuum of patient care. MedPAC further suggested that CMS strengthen incentive for providers to join ACOs by “offering a two-sided risk model in addition to the bonus-only model outlined in the statute.”
 
Meanwhile, the American Medical Association (AMA) endorsed a physician-led course of action and a range of new payment methods, in its comments. AMA said it hopes CMS will consider alongside the proposed “shared savings” method. It suggested easing antitrust restrictions would also go a long way to increasing physician collaboration in ACO implementation.



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