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Spotlight on ACOs

June 08, 2015 | Daily News

Lobbyists say the Senate Finance Committee is considering marking up a number of bipartisan health care bills that touch on issues ranging from anti-fraud, waste and abuse legislation to observation status notification to rural accountable care organizations, though a list of bills said to be under consideration, obtained by Inside Health Policy, indicates that no final decision has been reached on what could come before the committee.

June 04, 2015 | Daily News

CMS on Thursday unveiled a highly anticipated final rule for the second round of applications for accountable care organizations that will serve as the vehicle for expanding the Pioneer ACO demonstration.

May 29, 2015 | Daily News

CMS on Tuesday (May 28) announced a heart attack prevention initiative that the agency says is the largest test to date of a Medicare value-based pay model, and the Bipartisan Policy Center separately recommended ways to pay doctors for counseling patients on how to prevent health problems.

May 06, 2015 | Daily News

The White House Office of Management and Budget is reviewing CMS' final rule for the next round of contracts in the accountable care organization program, according to OMB's website.

May 04, 2015 | Daily News

CMS announced Monday (April 4) that for the first time it is using authority under the Affordable Care Act to expand a demonstration, called the Pioneer Accountable Care Organization Model, even though many Pioneer ACOs dropped out of that demo.

March 25, 2015 | Daily News

HHS said more than 40 organizations and states have come up with specific goals for alternative pay models as President Barack Obama and HHS Secretary Sylvia Burwell kicked off the Health Care Payment Learning and Action Network Wednesday (March 25).

March 19, 2015 | Daily News

While CMS and Blue Cross Blue Shield of Massachusetts are touting the success of alternative payment models, a new study by the American Medical Association and RAND Corp. says alternative pay systems alone are not enough to improve patient care.

March 10, 2015 | Daily News

CMS announced Tuesday (March 10) a third type of accountable care organization that will be allowed to operate more like Medicare Advantage plans.

March 05, 2015 | Daily News

CMS' Patrick Conway hinted at the direction CMS is taking on the next generation of accountable care organizations at a recent meeting on Capitol Hill. Conway spent more time talking about changes CMS is considering for advanced ACOs that accept the risk of financial penalties, but he also told Inside Health Policy that CMS is considering similar changes for so-called one-sided risk ACOs that share in savings without the risk of being penalized for missing cost and quality-of-care targets.

February 27, 2015 | Daily News

CMS opened an invitation to stakeholders across the industry to join the Health Care Payment Learning and Action Network to expand alternative payment models beyond Medicare and into Medicaid and the private sector and laid out details for how the forum will work.

February 09, 2015 | Daily News

The three new measures on Accountable Care Organizations in the president's budget would save $140 million over a decade, according to White House estimates, and they align with changes that providers seek in rulemaking for the second round of ACO contracts in the Medicare Shared Savings Program.

February 03, 2015 | Daily News

A private sector coalition spearheaded by CMS’ first innovation center head recommends a long list of changes to the accountable care organization program, including calls for new financial models, quality metrics based exclusively on patient outcomes, and automatic assignment of patients to ACOs in advance – with the chance to opt out -- so ACO providers know who to manage.

January 28, 2015 | Daily News

Several of the nation’s largest health care systems, insurance plans and employers announced Wednesday (Jan. 28) that they'll put 75 percent of their business into value-based payment arrangements by 2020, which is part of an effort by CMS and the private sector to align the public and private payer systems.

January 26, 2015 | Daily News

The goals CMS set Monday (Jan. 26) for moving providers to alternative pay models and value-based payments make it all the more important for physicians that Congress pass Medicare physician pay reform, provider lobbyists said, because Congress can pay doctors extra for simply participating in alternative pay models and CMS cannot.

January 21, 2015 | Daily News

Rural providers will meet CMS officials in early February to discuss a proposal that would enable them to participate in accountable care organizations, said Lynn Barr, founder of the National Rural Accountable Care Consortium.

December 04, 2014 | Daily News

The American Hospital Association says HHS' Office of Inspector General needs to change its “misbegotten” stance on the gainsharing Civil Monetary Penalty (CMP) rule, which the hospital group says would prohibit hospitals from rewarding physicians “for following protocols that call for the delivery of medically necessary services.”

December 01, 2014 | Daily News

Provider lobbyists offered a mixed initial reaction to a CMS proposal, released Monday (Dec. 1), to give accountable care organizations another three years without the risk of penalties, albeit with smaller shared savings for good performance.

December 01, 2014 | Daily News

The White House Office of Management and Budget finished reviewing CMS' proposed rule for the second round of accountable care organization contracts, according to OMB's website, and a hospital official following the rule said it's likely that CMS will propose the rule this week.

October 16, 2014 | Daily News

CMS and the HHS Office of Inspector General on Thursday (Oct. 16) extended waivers they had earlier granted for Accountable Care Organizations to get around some fraud and abuse laws, saying a proposed rule for the second round of the health law's Shared Savings Program is still in the works and the agencies would benefit from ACOs' input on whether the waivers are useful in their current form or should be changed.

October 15, 2014 | Daily News

CMS has decided to loan money to ACOs in rural and underserved areas in response to complaints that some accountable care organizations can’t afford the information technology systems or the changes to their practices that are needed to perform well enough to receive bonuses.

The initiative, unveiled Wednesday (Oct. 15), makes $114 million available to as many as 75 ACOs. CMS will recover those payments by paying less in shared-savings bonuses to ACOs that take out the loans, an agency release states.