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Spotlight on ACOs

March 23, 2013 | Daily News

CMS will give Pioneer ACOs an extra month to decide whether to remain in the high-profile health reform demonstration, and in the meantime the agency's innovation center is forming a group to deal with the quality metrics over which the accountable care organizations threatened to leave, although there is a good chance that some will still decide the demo is not a good fit for their organizations, sources say.

March 21, 2013 | Daily News

Congress should more aggressively change Medicare to let seniors choose alternatives to traditional Medicare, including medical homes, Medicare Advantage and accountable care organizations, and lawmakers should replace the physician pay formula with fixed rates the next two years, the bipartisan Partnership for the Future of Medicare recommends.

March 19, 2013 | Daily News

BOSTON -- Former CMS Administrator Donald Berwick says that the $1 billion Congress allocated to federal agencies for implementation of the Affordable Care Act is woefully inadequate and compared the funding level to attempting to travel to the moon with only a quarter of the money to build a rocket.

March 13, 2013 | Daily News

CMS is giving dialysis centers more time to apply for the agency's newly announced Medicare's kidney-care ACO demonstration, according to an agency update that cites a high level of interest from stakeholders as well as calls for more time to prepare applications.

March 08, 2013 | Daily News

Pioneer ACOs urged CMS to make changes to quality metrics prior to sending a letter threatening to drop out of the accountable care organization demonstration over those metrics, an earlier letter they sent to CMS reveals.

March 05, 2013 | Daily News

CMS plans to meet this month with Pioneer ACOs threatening to drop out of the high-profile demonstration to discuss their demands that the agency delay the requirement that they meet quality measures, CMS Acting Administrator Marilyn Tavenner told Inside Health Policy Tuesday (March 5).

March 01, 2013 | Daily News

One of CMS' highest profile health care delivery reform initiatives is on rocky ground as most of the Pioneer ACOs are threatening to drop out of the demonstration if CMS makes them start meeting quality measures instead of merely requiring that they report the measures, according to a letter obtained by Inside Health Policy.

February 26, 2013 | Daily News

The Brookings Institution's Hamilton Project is floating 15 proposals to reduce the federal budget deficit that include reforming Medicare cost-sharing, limiting the use of supplemental insurance and accelerating Medicare bundled payments.

February 22, 2013 | Daily News

CMS has awarded six states -- Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont -- over $250 million in innovation grants to implement a wide range of state-wide, multi-payer delivery system projects that HHS Secretary Kathleen Sebelius says let states take delivery reforms to the next level through coordination among private and public payers.

February 16, 2013 | Daily News

Kidney care provider DaVita told investors it may not participate in the kidney care accountable care organization demonstrations announced by CMS earlier this month, raising concerns that CMS' plan penalizes large organizations and those that have achieved savings in the past.

February 13, 2013 | Daily News

HHS Secretary Kathleen Sebelius and Medicare Director Jonathan Blum told stakeholders this week that the success of delivery system reforms are responsible for the recent slowdown in the growth of health care spending -- though the spending is often credited to the economy.

February 05, 2013 | Daily News

In a break from its traditional policy requiring primary care physicians to lead ACOs, CMS is testing a new way of paying for dialysis in a demonstration that creates kidney care accountable care organizations that are responsible for care offered to a group of matched beneficiaries, not only dialysis care or care specifically related to a beneficiary’s kidney failure.

January 10, 2013 | Daily News

As accountable care organizations catch on, they could save up to $940 million over four years, CMS said Thursday (Jan. 10) as it announced 106 new ACOs, bringing to about 250 the number of ACOs formed since passage of the health reform law, which applied the ACO concept to Medicare.

December 31, 2012 | Daily News

CMS Principal Deputy Administrator Jonathan Blum told Inside Health Policy the agency is considering allowing specialists to form accountable care organizations as demonstrations, which would be a break from the health law's strong disposition toward primary physician-run ACOs.

December 11, 2012 | Daily News

CMS Medicare chief Jonathan Blum said Monday (Dec. 10) that CMS is considering new pay systems for oncology services, including the way that expensive cancer drugs are reimbursed under Part B.

December 06, 2012 | Daily News

A first-ever finding by the Congressional Budget Office that Medicare costs go down when seniors take their drugs could boost CMS' interest in letting Part D plans share in savings resulting from medication adherence and letting the private plans integrate with accountable care organizations to work on medication adherence.

November 27, 2012 | Daily News

CMS on Nov. 20 sent Medicaid directors guidance on the essential health benefits that states must offer to residents who are newly eligible for Medicaid, and, for the most part, the regulations that apply to private insurance sold in the exchanges will apply to Medicaid, but CMS nevertheless will soon propose a separate regulation on Medicaid essential health benefits.

November 13, 2012 | Daily News

A number of innovation programs under CMMI will be expanded in the near future, CMMI Director Richard Gilfillan told members of the National Business Coalition on Health Tuesday (Nov. 13), as the agency moves forward testing new models of delivery system reform.

October 17, 2012 | Daily News

CMS Innovation Center head Richard Gilfillan says federal officials this week began discussing with providers 48 episodes of care that CMMI is proposing be a part of its bundled payment initiative, which seeks to transition providers away from fee-for-service reimbursement in Medicare but was dealt at least a temporary setback after CMS recently decided to suspend implementation of one of the initiative’s models.

October 15, 2012 | Daily News

Children's hospital representatives are in the early stages of talking to some states interested in expanding medical home programs, and one option might include CMS paying a greater federal match to states to fund health homes for the first two years to set up infrastructure, said Aimee Ossman, director of policy analysis at the National Association of Children's Hospitals.