The Congressional Budget Office expects a lot more seniors to enroll in Medicare Advantage plans than it did just a year ago, and health care consultancy firm Marwood Group said CBO's projections are conservative.

A bipartisan group of lawmakers from Pennsylvania has asked CMS to extend the Medicare Coordinated Care Demonstration, which is slated to terminated June 30, because they say it saves money and improves care, if only for the riskiest patients at a single demo location.

Pioneer ACOs looking to direct patients to lower-cost post-acute care settings recently received a primer on a study funded by the home-health industry that shows patients often could be discharged to lower-cost settings, according to Allen Dobson, president of the health economics firm Dobson | DaVanzo & Associates, which conducted the research.

CMS' Innovation Center is planning a second round of health care innovation grants that will divvy up $1 billion for creative projects focused on four specific payment and delivery reform models that fill in what CMMI Director Richard Gilfillan said Wednesday (May 15) were identified as gaps after the first round.

A top policy official at DaVita, who was “bummed” in February about CMS' terms for participation in the kidney care ACO demonstration, told investors the dialysis chain is now optimistic the agency will change the demo enough for the company to participate, although company officials say CMS has not indicated it will make the changes sought by DaVita.

CMS is lowering the minimum number of beneficiaries required for organizations to participate in Medicare's kidney-care ACO demonstration, now requiring that organizations have 350 matched beneficiaries to participate as opposed to 500.

Yet another bipartisan group, Brookings Institution's Engelberg Center for Health Care Reform, suggests that Congress build on accountable care organizations (ACOs) by transitioning fee-for-service Medicare to what it calls Medicare Comprehensive Care (MCC) organizations in which seniors would enroll and share in savings, a proposal resembling the Medicare Networks that the Bipartisan Policy Center recommended last week.

CMS has rejected Pioneer ACOs' demands for a delay in the Pioneer demonstration's pay-for-performance phase but has agreed to speed up integration of real-time data into the quality metrics on which performance is based and soon will update those metrics in a rulemaking that will extend to all accountable care organizations, the agency states in an April 23 letter obtained by Inside Health Policy.

A bipartisan think tank founded by former Republican and Democratic congressional leaders issued a long-promised health care overhaul framework that offers a new twist on accountable care organizations by proposing Medicare Networks that, unlike ACOs, would discount premiums for seniors who choose the networks.

CMS should consider letting seniors share in savings from accountable care organizations to shield ACOs from the potential backlash that HMOs experienced in the 1990s, Medicare Payment Advisory Commission Chair Glenn Hackbarth said at the group's meeting this month.

ACOs might be a spring board to Medicare Advantage and other capitated-pay models, according to some MedPAC commissioners and accountable care organization representatives.

Accountable Care Organizations are locating primarily where Medicare Advantage is strong, according to Congress' Medicare advisers, who on Thursday (April 4) will review research on the some 250 ACOs, but there are some exceptions that could be interesting, according to a consultant.

If biopharmaceutical and medical device makers wish to avoid Medicare spending cuts, they should push for ACO performance measures that pay for results, rather than relying on contracts that pay accountable care organizations (ACO) rebates for using more of their products, former CMS Administrator Mark McClellan said. McClellan, who was also FDA commissioner under President George W. Bush, also said ACOs could be the future of personalizing medicine.

CMS will give Pioneer ACOs an extra month to decide whether to remain in the high-profile health reform demonstration, and in the meantime the agency's innovation center is forming a group to deal with the quality metrics over which the accountable care organizations threatened to leave, although there is a good chance that some will still decide the demo is not a good fit for their organizations, sources say.

Congress should more aggressively change Medicare to let seniors choose alternatives to traditional Medicare, including medical homes, Medicare Advantage and accountable care organizations, and lawmakers should replace the physician pay formula with fixed rates the next two years, the bipartisan Partnership for the Future of Medicare recommends.

BOSTON -- Former CMS Administrator Donald Berwick says that the $1 billion Congress allocated to federal agencies for implementation of the Affordable Care Act is woefully inadequate and compared the funding level to attempting to travel to the moon with only a quarter of the money to build a rocket.

CMS is giving dialysis centers more time to apply for the agency's newly announced Medicare's kidney-care ACO demonstration, according to an agency update that cites a high level of interest from stakeholders as well as calls for more time to prepare applications.

Pioneer ACOs urged CMS to make changes to quality metrics prior to sending a letter threatening to drop out of the accountable care organization demonstration over those metrics, an earlier letter they sent to CMS reveals.