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Spotlight on 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.

October 24, 2019 | Daily News

CMS opened applications for two of its new Medicare alternative payment models on Thursday (Oct. 24) as the Health Care Payment Learning and Action Network (LAN) officially laid out its goals to move all Medicare beneficiaries to value-based pay models by 2025.

October 22, 2019 | Daily News

Accountable care organizations praised a bipartisan Senate bill introduced Tuesday (Oct. 22) that would remove ACO patients from the regional comparison group when CMS sets benchmarks, fixing what the ACOs call the “rural glitch.”

October 21, 2019 | Daily News

A key house panel is poised to mark up this week legislation that slaps a tax on nicotine concentrates used for vaping, and another that lets consumers use tax-free health savings accounts to pay for direct pay primary care arrangements.

October 16, 2019 | Daily News

Health experts at the Urban Institute and Commonwealth Fund analyzed eight health reform proposals ranging from building off the Affordable Care Act to transitioning to a full single-payer system that covers all people in the country in a bid to help policymakers and voters understand the trade-offs of each option.

October 16, 2019 | Daily News

While many industry attorneys praise the administration’s proposed Stark Law and anti-kickback statute reforms, some provider groups are skeptical the changes would help make much difference for those navigating the regulations, particularly for those in rural areas, and suggest Congress needs to step in.

October 09, 2019 | Daily News

HHS on Wednesday (Oct. 9) released long-awaited proposals to change the physician-self referral and anti-kickback statute regulations aimed at easing providers’ participation in value-based pay models, including new, permanent exceptions to the Stark Law for value-based pay arrangements within and outside Medicare and a new safe harbor under the anti-kickback statute for certain incentives beneficiaries can access through CMS demonstrations.

October 08, 2019 | Daily News

Days after CMS unveiled a tool to help employers who are thinking about funding a health reimbursement account that workers can use to buy individual coverage (ICHRA), a private company launched a similar, interactive affordability calculator and administrative platform that can facilitate the new coverage option finalized in July.

October 02, 2019 | Daily News

An innovation center official told physicians that by 2025 the center aspires to move all Medicare fee-for-service beneficiaries into alternative pay models that include a significant amount of risk for providers.

September 27, 2019 | Daily News

Accountable Care Organizations on Friday (Sept. 27) again pushed against a new beneficiary notification requirement that is part of CMS’ ACO overhaul, but CMS says it won’t budge on the requirement just yet.

September 18, 2019 | Daily News

Traditional Medicare remains the driver of risk-based pay models, according to a report released by Premier Inc. Tuesday (Sept. 17), but a Premier official said progress is slower than the hospital group had hoped for as few providers surveyed expect their total patient percentage in these models to exceed 50% within five years.

September 12, 2019 | Daily News

The National Association of Accountable Care Organizations (NAACOS) called on CMS to pay close attention to what it sees as a dip in the number of new ACO participants for 2019 and lays out recommendations that could help entice new organizations to join the program.

September 03, 2019 | Daily News

CMS delayed requirements for accountable care organizations (ACOs) to notify beneficiaries of their assignment in order to give ACOs time to adjust, but the providers still want the requirement removed.