New Shared Savings Program Enhances ACOs

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  • April 12, 2012
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Twenty-seven accountable care organizations (ACOs) have signed on to the new Medicare Shared Savings Program (Shared Savings Program) with the Centers for Medicare & Medicaid Services (CMS), taking responsibility for quality of care furnished to Medicare subscribers. If successful, the ACOs will get a piece of the savings realized through better care, CMS said.
The Shared Savings Program and other ACO-related activities are made possible through the Patient Protection and Affordable Care Act of 2010. The 27 ACOs will serve approximately 375,000 Medicare beneficiaries in 18 states and help raise the number of organizations participating in Medicare savings initiative to 65. This includes 32 pioneer ACOs and six physician group practice transition demonstration organizations. Five ACOs are participating in the Advance Payment model beginning this month. CMS said more than 1.1 million Medicare beneficiaries are participating, and the selected ACOs include more than 10,000 physicians, 10 hospitals, and 13 smaller physician-driven organizations in both urban and rural areas. Their models for coordinating care and improving quality vary in response to the needs of the beneficiaries in the areas they are serving. CMS is reviewing 150 more applications for programs starting in July, with 50 of those applying for the Advance Payment option.
For the first year of the program the final rules offered ACOs the option of starting on either April 1 or July 1, 2012. Later this year, CMS will announce the date for application submission to participate in the Shared Savings Program beginning in 2013.
CMS published a final rule in the Federal Register Nov. 2, 2011, establishing the Shared Savings Program. The final rule addressed issues relating to eligibility, governance, beneficiary rights, quality measures and performance scoring, and CMS monitoring of ACO operations. At the same time, the Innovation Center announced an Advance Payment ACO model to test whether providing advance payments from anticipated savings could encourage certain rural and physician-based entities to apply to participate in the program, increasing the amount and speed at which ACOs can improve care for beneficiaries and generate Medicare savings, CMS said.

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