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CMS issues more incentives for ACOs

May 19, 2011

New initiatives aimed at encouraging healthcare providers to join Accountable Care Organizations (ACO) were recently announced by the Centers for Medicare and Medicaid Services (CMS).

The ACO proposal was introduced in March, and CMS says the program will help Medicare achieve up to $430 million in savings over a three-year period by increasing collaborative care among providers.

Dr. Jeremy A. Lazarus, speaker of the American Medical Association’s (AMA) House of Delegates, said in April that in order to achieve the CMS’ vision, barriers such as the required large capital investments and certain federal policies will have to be addressed.

With the introduction of three new options for providers, the CMS hopes to remove some of these challenges so more doctors and hospitals will work to create a coordinated care system.

“Over and over again, we have seen that improving how care is delivered to patients is key to reducing the growth in healthcare spending,” said CMS administrator Dr. Donald M. Berwick. “When we improve the coordination of care between providers, reduce duplication of services and avoid medical errors, we can get better outcomes for patients at less cost.”

The first initiative, the Pioneer ACO model, is designed with mature provider organizations in mind. The model will be available to advanced organizations that have already launched some form of collaboration within their systems. It creates a faster path for those groups ready to participate in the program by implementing alternative payment processes, and aims to foster greater partnering with private payers in order to realize the improved care quality and cost reductions.

To enroll in this model, providers must send a letter of intent by June 10 and submit their full applications by July 18.

Another initiative is an advance payment ACO model, which will give some groups access to their shared savings in order to bankroll the needed investments in extra staff members and added infrastructure – such as electronic health record systems.

The final proposed initiative is a series of four free information sessions directed toward providers that are not yet ready to join an ACO but that are interested in learning more about the process. The first two-day session will be held in Minneapolis, Minnesota, beginning on June 20, and will also be available for viewing via webcast.

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