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Spotlight on ACOs

September 21, 2018 | Daily News

Rep. Suzan DelBene (D-WA) is drumming up support for a letter that will ask CMS to adjust the low-volume threshold in order to include more providers in the Merit-based Incentive Payment System as part of the final 2019 physician fee schedule – an agency move that would be supported by some stakeholders like Premier and the American Medical Group Association even though the American Medical Association and others want CMS to finalize the exemption as proposed.

September 20, 2018 | Daily News

A White House budget official said HHS is being extremely deliberative about potential changes to to the Stark, or physician self-referral, and anti-kickback statutes because making changes the wrong way could increase fraud and abuse and hurt Medicare’s budget.

September 11, 2018 | Daily News

The National Association of Accountable Care Organizations and Institute for Accountable Care say CMS should back away from cuts to the shared savings rate for ACOs in its new model, give providers at least three years and as many as five before they need to take on risk and allow beneficiary risk scores to change by up to 5 percent during ACO contracts.

September 06, 2018 | Daily News

HHS Secretary Alex Azar on Thursday (Sept. 6) said that moving to value-based care may require mandatory models under the CMS innovation center, as well as other mandatory reforms, but at the same time Azar said HHS doesn’t want to micromanage how providers reach good outcomes.

September 05, 2018 | Daily News

House Ways & Means Chair Kevin Brady (R-TX) and health subcommittee Chair Peter Roskam (R-IL) welcomed CMS' efforts to revamp Medicare accountable care organizations and said they appreciate the agency's proposal to extend current contracts by six months to prevent the mass exit of ACOs -- but they also asked the agency to reconsider reducing shared savings down to 25 percent for those ACOs that don't take on risk.

August 31, 2018 | Daily News

Medicare ACOs saved the program $314 million in 2017, which the National Association of Accountable Care Organizations says shows ACOs' value -- but CMS says the fact that 2017 is the first time ACOs wielded net savings underscores a need to overhaul the Medicare Shared Savings Program.

August 30, 2018 | Daily News

CMS innovation center director Adam Boehler on Thursday (Aug. 30) suggested accountable care organizations opting not to participate in the overhauled Medicare Shared Savings Program could pursue other value-based care avenues, including a direct-provider contracting initiative or bundled pay.

August 29, 2018 | Daily News

CMS said the Next Generation Accountable Care Organization's first year report shows the model is promising, and the evaluation says the results from that model are comparable to those for the early Pioneer ACOs and better than the early years of the Medicare Shared Savings Program.

August 10, 2018 | Daily News

CMS is proposing a major revamp of the Medicare Shared Savings Program Accountable Care Organizations, including a plan to give new ACOs only two years before they must start sharing both savings and losses with the agency.

August 07, 2018 | Daily News

The White House Office of Management and Budget finished on Monday (Aug. 6) its review of a proposed rule that is expected to make changes to the Medicare Shared Savings Programs Accountable Care Organizations, including a transition to performance-based risk, more waivers and polices CMS says will make ACOs more sustainable.

July 30, 2018 | Daily News

The National Association of Accountable Care Organizations wants CMS to create a direct channel for ACOs to report suspected fraud and abuse, but CMS Center for Program Integrity Director Alec Alexander, when pressed on that at a recent hearing, said there are already methods for providers to report such concerns.

July 26, 2018 | Daily News

Representatives from five doctors' groups told the House Energy & Commerce health subcommittee Thursday (July 26) that Congress should retain the Merit-based Incentive Payment System, rather than scrap it as the Medicare Payment Advisory Commission has suggested, as doctors are better off under MIPS than they were under the old Sustainable Growth Rate formula.

July 12, 2018 | Daily News

CMS proposed tweaks to the low-volume exception process for the Merit-based Incentive Payment System, including allowing some otherwise excluded providers to opt-in to MIPS, in a rule released Thursday (July 12), but despite GOP lawmakers' urging, the agency did not lower existing threshold criteria to require more doctors to participate.

June 20, 2018 | Daily News

CMS on Wednesday (June 20) asked stakeholders for feedback on how the physician self-referral law, or Stark law, exemptions are working and what changes are needed to reduce barriers to care coordination for alternative pay models.

June 20, 2018 | Daily News

Hospitals, doctors and health systems groups are asking CMS to give providers more time to decide whether to participate in the new Bundled Payments for Care Improvement Advanced model, given that providers only received important data and information on the model in the beginning of June.

June 13, 2018 | Daily News

HHS Secretary Alex Azar said he is interested in two of the alternative pay models recommended by the Physician-Focused Payment Technical Advisory Committee, and he praised P-TAC’s work.

June 08, 2018 | Daily News

Stakeholders who work with accountable care organizations pushed back against suggestions from Trump administration officials that ACOs need to take on more financial risk, and one stakeholder said he hopes CMS uses an upcoming proposed rule on ACOs to adjust how it handles regional benchmarking and risk adjustment.

June 04, 2018 | Daily News

Avalere says 21 percent of cancer patients in Part B fee-for-service received care in 2017 from doctors participating in the Oncology Care Model -- a demonstration that the Community Oncology Alliance says still falls short even though CMS has addressed some of the group's concerns.

May 03, 2018 | Daily News

The new director of the Center for Medicare and Medicaid Innovation said Thursday (May 3) that he wants to use his new role to reduce regulatory burdens, promote better sharing of data and encourage value-based care through models that would not necessarily involve providers taking on more risk.

May 02, 2018 | Daily News

The White House Office of Management and Budget is looking at a proposed rule that would make changes to the accountable care organization program, including a transition to performance-based risk, more waivers and policies CMS says will make the ACO program sustainable, according to the office's website.

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