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Spotlight on ACOs

April 24, 2014 | Daily News

Lobbyists expect CMS to propose major ACO policy changes this fall aimed at keeping accountable care organizations from dropping out during the second round of contracts in the program, which agency officials often tout as a key example of how the Affordable Care Act is reforming the health care system.

April 23, 2014 | Daily News

After numerous setbacks and delays, CMS latest revisions to the kidney care ACO effort are viewed as the agency's final bid to secure the participation necessary to make the demonstration a success, and some stakeholders predict that changes to the rebasing policy will make it much easier for CMS to reach its participation goals while others note the agency has not met all of industry's demands.

April 15, 2014 | Daily News

CMS on Tuesday (April 15) re-opened the End Stage Renal Disease Seamless Care Organization demonstration with a revised Request for Applications following discussions and feedback from the industry, which had previously pushed CMS to reconsider some of the demo's quality measures and performance benchmarks.

March 05, 2014 | Daily News

CMS is asking physicians for advice on how to get small practices to participate in alternatives to fee-for-service Medicare, such as accountable care organizations and medical homes, because the agency thus far has focused on hospitals and health systems, CMS Administrator Marilyn Tavenner said Wednesday (March 5) at an American Medical Association conference in Washington.

March 01, 2014 | Daily News

North Carolina hopes to begin moving its Medicaid population to accountable care organizations beginning in July 2015, and Gov. Pat McCrory (R) recommended to the Medicaid Reform Advisory Committee that North Carolina Medicaid be revamped using shared savings instead of capitated managed care focused on care coordination and budget predictability.

February 19, 2014 | Daily News

The Advanced Medical Technology Association is pushing for CMS to make adjustments in its payment methodology for accountable care organizations (ACOs) and bundled payment programs as well as make changes to its coverage determination policy to ease new technologies to market, the organization said Tuesday (Feb. 18) as part of the group's priorities for the coming year.

January 30, 2014 | Daily News

CMS announced early results from its initiatives on accountable care organizations: Nearly half of the 114 ACOs in the Medicare Shared Savings Program had lower expenditures than expected, 29 of which received bonuses (shared savings) totaling $126 million in the first year and generated $128 million in savings for Medicare; Pioneer ACOs, which are part of a separate initiative, generated gross savings of $147 million in their first year; and the participants of the Physician Group Practice Demonstration earned a total of $108 million in bonuses over five years for improving the quality of care and lowering costs.

January 22, 2014 | Daily News

Thirty-five state Medicaid programs have expanded to reimburse peer-support specialists since 2001, which experts in the mental and substance abuse fields say is a sea-tide of change that could eventually result in validation and creation of a profession that fits well with accountable care organizations and the push for value-based purchasing.

January 03, 2014 | Daily News

The National Quality Forum is speeding its review of quality measures, including those that need to be retired, and NQF and CMS officials are considering changes to how measure-development is funded in anticipation of a flood of new quality measures as Congress and CMS move toward rewarding good care and penalizing poor care, says NQF President and CEO Christine Cassel.

December 27, 2013 | Daily News

Family doctors tout new survey results as part of their bid to keep physician assistants and nurse practitioners from taking responsibility for many of the services for which doctors are responsible.

December 20, 2013 | Daily News

CMS is seeking advice on whether it should expand the pioneer accountable care organization demonstration and wants input on whether to transform ACOs of all types to a “full insurance risk” model like Medicare Advantage plans, whether to add the drug benefit to ACOs and whether to make ACOs accountable for Medicaid outcomes.

November 19, 2013 | Daily News

Medicaid directors are looking toward patient-centered medical homes, with or without an accountable care organization attached, to curb spending and improve the quality of care.

November 19, 2013 | Daily News

The hospital value-based purchasing program leaves more hospitals with pay cuts than bonuses, with about half of hospitals breaking even, according to new CMS calculations of the value-based purchasing payment incentives.

November 13, 2013 | Daily News

The National Nursing Centers Consortium is urging CMS to replace its term “primary care physician” with “primary care clinician” in little-noticed guidelines sent recently to Arkansas on its patient centered medical home plan.

November 08, 2013 | Daily News

Congressional Medicare payment advisers are considering recommending changes for the second round of the Medicare ACO program, but first hope to determine whether accountable care organizations should remain a niche or whether the program should be spread widely.

October 07, 2013 | Daily News

Hospitals -- feeling pressure from tightening payments from government and private payers, and from HHS to beef up systems that base care on quality and volume -- are eagerly turning to insurance-like business models.

September 12, 2013 | Daily News

Congressional Medicare advisers on Thursday (Sept. 12) discussed the prospect of offering ACO beneficiaries Medigap plans with low premiums and reduced cost sharing when they visit in-network providers.

August 30, 2013 | Daily News

CMS is not interested in partnering with states on Medicaid shared savings programs based on cost savings alone, saying the programs must improve quality and health outcomes, according to agency guidance released Friday (Aug. 30) laying out what states need to consider when designing and implementing such initiatives.

August 15, 2013 | Daily News

A little-noticed Arkansas initiative to require most insurers, including those working with exchanges, to participate in a state-wide episode-based pay initiative is viewed as a possible game changer.

July 31, 2013 | Daily News

An elder care center is applying to CMS to test an ACO-like organization that would care for the frail elderly, which some seniors advocates believe could be a model for overhauling the long-term care system to handle the coming wave of dependent elderly.