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Spotlight on ACOs

August 03, 2020 | Daily News

Long-awaited legislation to tweak accountable care organizations – and in some cases walk back aspects of the administration's program revamp – was recently introduced by Reps. Suzan DelBene (D-WA), Peter Welch (D-VT) and Darin LaHood (R-IL) -- though some lobbyists say it’s unlikely Congress will have the appetite to take up the bill as much of lawmakers’ focus has been on the COVID-19 pandemic.

July 17, 2020 | Daily News

The non-partisan, non-profit United States of Care, founded by former CMS Administrator Andy Slavitt and other health policy experts such as former Senate Majority Leader Bill Frist, urge Congress to include in the upcoming COVID-19 relief bill funding for a Health Care Resilience Program that would grant advanced payments or loan forgiveness to providers who agree to accelerate their transition to value-based care.

July 13, 2020 | Daily News

Accountable care organizations are in favor of increased use of telehealth during the public health emergency but are raising concerns that such e-visits may attach beneficiaries to ACOs without continued engagement.

June 03, 2020 | Daily News

CMS on Wednesday (June 3) said, due to the COVID-19 pandemic, it will extend some innovation center models, including the Next Generation Accountable Care Organizations, while delaying the start date for others.

May 20, 2020 | Daily News

The National Association of Accountable Care Organizations is urging CMS to extend the Next Generation ACO demo for at least a year -- especially given issues stakeholders have run into with the Direct Contracting model that CMS said could act as the next step for Next Generation ACOs -- and to protect those in the demo from negative side effects of COVID-19.

May 14, 2020 | Daily News

Accountable care organizations, health systems, doctors, teaching hospitals and others are pleased with CMS’ moves to mitigate the effects of the COVID-19 outbreak on ACOs, but they also say more steps could be taken to keep the providers interested in value-based pay.

April 30, 2020 | Daily News

CMS will mitigate losses by accountable care organizations from January until the end of the COVID-19 public health emergency, the agency says in broad interim final rule released Thursday (April 30), and the agency also says it will exclude beneficiaries’ COVID-19 inpatient care episodes from ACO spending, give ACOs the option not to take on increased risk in 2021, allow ACOs with expiring contracts to extend them through 2021 and use telehealth claims to help assign beneficiaries to the correct ACOs.

April 28, 2020 | Daily News

The American Hospital Association is pressing CMS to go beyond the extreme and uncontrollable circumstances policy it put in place for the Comprehensive Care for Joint Replacement demonstration and hold hospitals harmless for any penalties in the program in 2020 due to COVID-19.

April 23, 2020 | Daily News

Sens. Sheldon Whitehouse (D-RI) and Bill Cassidy (R-LA) are pressing CMS to go further with relief for accountable care organizations as a result of the COVID-19 pandemic and waive the providers’ losses they might otherwise have to repay -- a step that the National Association of ACOs has urged both Congress and CMS to consider.

March 31, 2020 | Daily News

CMS is easing the extreme and uncontrollable circumstances policies for accountable care organizations and the hip-and-knee replacement demonstration, as well as adding flexibility to the Medicare Diabetes Prevention Program in an interim final rule unveiled Monday (March 30).

March 31, 2020 | Daily News

The National Association of Accountable Care Organizations estimates the COVID-19 pandemic could cost Medicare up to $115.4 billion over the next year, and derail Medicare ACOs.

March 23, 2020 | Daily News

CMS on Sunday (March 22) announced exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs -- including accountable care organizations and the Merit-based Incentive Payment System -- but the agency hasn’t yet laid out what it will do about 2020 data for MIPS and ACOs.

March 19, 2020 | Daily News

Stakeholders are urging CMS and lawmakers to make sure the COVID-19 pandemic doesn’t derail providers in value-based pay arrangements, including in accountable care organizations, with some warning of potential mass exits from such arrangements due spending spikes driven by coronavirus care and treatment.

March 06, 2020 | Daily News

Congress’ Medicare advisors on Thursday (March 5) discussed reworking accountable care organizations’ benchmarks by recommending that CMS use National Provider Identifiers to figure out which providers are part of an ACO and compute their performance year and baseline spending.

January 10, 2020 | Daily News

CMS says the revamped Medicare Shared Savings Program Accountable Care Organizations are on track to save $2.9 billion over 10 years, as the agency’s actuary projected when the regulatory overhaul was finalized, but the National Association of ACOs raises concerns about the program’s lack of growth because it says fewer new ACOs are joining the program than in past years.

January 10, 2020 | Daily News

CMS’ evaluation of the Next Generation Accountable Care Organization’s second year shows that Medicare spending increased slightly during 2017, though the National Association of ACOs said those results are likely due in part to the way the evaluation compared their performance to others.

January 08, 2020 | Daily News

CMS on Monday (Jan. 6) touted that about 98% of providers in the Merit-based Incentive Payment System received a bonus or avoided a pay cut for the program’s second performance year, 2018, but some stakeholders say that a budget-neutral system where everyone does well doesn’t provide the necessary incentives to move providers to value-based pay and the program is becoming more of a compliance exercise than motivation for providers to move away from fee-for-service.

January 06, 2020 | Daily News

The former CEO of Anthem’s Diversified Business Group will lead the Center of Medicare and Medicaid Innovation, CMS announced Monday (Jan. 6), replacing former Adam Boehler who stepped down as director last year.

December 02, 2019 | Daily News

Accountable Care Organizations view CMS’ new Direct Contracting demonstration as laying the groundwork for the next generation of ACOs -- particularly with the Next Generation ACO demo set to sunset soon -- and PACE organizations view the Direct Contracting demo as a way to reach new patients who could benefit from the Program of All-Inclusive Care for the Elderly care model.

October 29, 2019 | Daily News

Less than a week after CMS delayed the implementation of its new alternative payment model for primary care, HHS Secretary Alex Azar on Tuesday (Oct. 29) touted the model as a centerpiece of the Trump administration’s conservative vision for Medicare.