CMS Announces ACE Demonstration Sites

Beginning early this year, a hand-picked group of health care institutions will help the Centers for Medicare & Medicaid Services (CMS) test a theory that bundled payments for both Part A hospital and Part B physician services will improve the quality of care fee-for-service (FFS) Medicare beneficiaries receive, produce savings, align incentives, and increase collaboration. CMS announced Jan. 6 its site selections for the Acute Care Episode (ACE) Demonstration.

Value-based care center sites that will participate in the ACE Demonstration are: Baptist Health Hospital LLC in Oklahoma City, Okla; Exampla Saint Joseph Hospital in Denver, Colo; Hillcrest Medical Center in Tulsa, Okla; and Lovelace Health System in Albuquerque, N.M.

Physicians currently paid under the Medicare Physician Fee Schedule (MPFS) and Medicare beneficiaries will be “marketed” to encourage participation in the demonstration, CMS says, which will focus on 28 cardiac and nine orthopedic inpatient surgical procedures.

Read the Jan. 6, CMS press release for further details.

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4 Responses to “CMS Announces ACE Demonstration Sites”

  1. Sherry Gann, CPC says:

    Unless a physician works for the hospital or the physician’s base is hospital owned I do not understand how this will work. Who gets the money? How will they divide it out? What about Stark, could this be in violation of that Law or will it cause it to become an issue. CMS has cut physician’s fees to the point that primary care doctors in private practice can’t even meet their practice costs. Will insurnce companies try and follow this model and change the course of healthcare? If you have additional resources regarding this program I would really like to look into it futher.

    Thanks

  2. B W Sox says:

    THIS IS NOT A GOOD PLAN. HOW WILL THE $$ BE DIVIDED? WHO WILL RECEIVE THESE $$?
    WHO WILL PAY THE PHYSICIANS? WHO WILL PAY THE HOSPITAL?

    NOT A GOOD PLAN. MUST THINK UP A BETTER WAY TO REIMBURSE SEPARATE PROVIDERS?

    WHAT IS WRONG WITH THE WAY IT IS DONE NOW? EACH PROVIDER IS RESPONSIBLE FOR HIS/HER OWN WORK, BILLING, FOLLOW UP, APPEALS, ETC.

    WHY DOES CMS CONTINUE TO DEVISE METHODS TO MAKE IT HARDER FOR PROVIDERS TO DEAL WITH AND ALSO CONTINUE TO REDUCE ALREADY RIDICULOUSLY LOW REIMBURSEMENT $$.

    DON’T UNDERSTAND IT!!

    B.W. SOX

  3. Pawan Arya, MBA, CPC, CPC-H says:

    I think the idea is good and would achieve its goals of improving quality of care and reduce costs. The program requires formation of Physician Hospital Organization (PHO) in order to participate in the demonstration project. The payment will be received by the PHO and divided among physicians and hospital based on facility fee and physician fee. In addition, the physician could receive up to 25% of the savings that is derived under this model (at least it is assumed there will be saving). The reason why saving is anticpation is becasue of better coordination of care between providers of care to achieve results. It is not uncommon to see patients in hospitals waiting for their tests to be scheduled or drug orders increasing the length of stay and there by raising the cost of care.

    With new model, there is disincentive to physcians for prolonging patient stay at hospital. This is movement towards prospective payment system for physicians for inpatients.

    Watch out!!! Prospective Payment for phyisican offices is not too far off.

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