CMS Initiates New Program to Support Care Coordination Among ACOs
Many of you are aware of the recently published Centers for Medicare & Medicaid Services (CMS) Affordable Care Act (ACA) initiative to support care coordination nationwide.
CMS announced the availability of a new initiative for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. The initiative is designed to encourage ACOs to realize quality improvement and care coordination through the use of health information technology; thereby helping to move the health care system to one that values quality over quantity, and preventative care over treating people after they get sick. The new ACO Investment Model is designed to bring these efforts of better coordinated care to rural and underserved areas by providing up to $114 million in upfront investments to up to 75 ACOs across the country.
“The ACO Investment Model will give Medicare Accountable Care Organizations more flexibility in setting quality and financial goals, while giving them greater accountability for delivering quality care efficiently,” said CMS Administrator Marilyn Tavenner. “We are working with these organizations to make necessary investments that encourage doctors, hospitals and other health care providers to work together to better coordinate care and keep people healthy.”
Through the CMS Innovation Center, this initiative will provide up front investments in infrastructure and redesigned care process to help eligible ACOs continue to provide higher quality care. This will help increase the number of beneficiaries — regardless of geographic location — that can benefit from lower costs and improved health care through Medicare ACOs. CMS will recover these payments through an offset of an ACO’s earned shared savings. Eligibility is targeted to ACOs who joined the Shared Savings Program in 2012, 2013, 2014, and to new ACOs joining the Shared Savings Program in 2016. The application deadline for organizations that started in the Shared Savings Program in 2012 or 2013 will be December 1, 2014. Applications will be available in the Summer of 2015 for ACOs that started in the Shared Savings Program in 2014 or will start in 2016.
Gorman Health Group has assisted numerous organizations for the past three years in achieving Pioneer and Shared Savings ACO status. Additionally, GHG has assisted operating ACO’s in analyzing operating and medical spend performance. If you, as an ACO, are wondering why shared savings expectations are not being realized, or how to improve on your internal analytical and decision support competencies — we can meet your needs. Contact us today.
Resources
On Friday, September 26, John Gorman, GHG’s Founder and Executive Chairman together with colleague, John Nimsky, Senior Vice President of Healthcare Innovations, discussed the vehicles for achieving what could be characterized as a reengineering of the health care delivery process and its effectiveness. Join the Point today to access this webinar recording.
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