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Spotlight on ACOs

December 21, 2010 | Daily News

Some provider organizations have volunteered to take a financial risk if the agency decides to follow the Medicare Payment Commission's call for a “two-sided risk” model for accountable care organizations, but an agency official warned Monday that this model might provide an advantage for larger provider organizations with enough capital to cope with the financial risk.

December 14, 2010 | Daily News

Physician and hospital advocates are urging CMS to use the widely accepted National Quality Forum-endorsed quality measures to evaluate the performance of health reform's accountable care organizations, while patient advocates, along with the Medicare Payment Advisory Commission, urge CMS to also include patient experience assessments.

December 09, 2010 | Daily News

CMS is facing pressure to back off the idea of using a retrospective beneficiary assignment process as it shepherds the establishment of accountable care organizations, with Congress' Medicare Payment Advisory Commission, AARP and other key stakeholders instead advocating prospective assignment under the health reform delivery model.

December 04, 2010 | Daily News

CMS Administrator Donald Berwick said on Friday that the accountable care organization proposed rule – initially planned to be issued later this month – has been pushed back to mid-January at the earliest. Berwick made the announcement the same day the comment period ended for the agency's request for information from stakeholders on key issues surrounding formulation of the ACO proposed rule mandated by health reform.

December 03, 2010 | Daily News

Congress' Medicare Payment Advisory Commission is urging CMS to strengthen incentives for Accountable Care Organizations to improve quality and save money by proposing that the organizations not just receive bonuses for good performance, but also face penalties when they don't cut costs. If CMS believes it can't implement such an approach under the health reform law's shared-savings program, MedPAC says, the agency should test out the idea under ACO demonstrations shepherded by the law's new Center for Medicare and Medicaid Innovation.

November 29, 2010 | Daily News

As CMS puts the finishing touches on its accountable care organization proposed rule, a bipartisan group of 17 House lawmakers is asking the agency to let specialists form ACOs, if those specialists also provide primary care. A recent Congressional Research Service report also broached the idea of specialty ACOs.

November 18, 2010 | Daily News

The insurance and the hospital lobbies plan to hold a joint meeting with CMS officials next week to review existing accountable care organizations (ACOs) in the private sector and discuss ways to ensure the agency's upcoming rulemaking does not undermine those operations.

Karen Ignagni, president and CEO of America's Health Insurance Plans (AHIP), and Richard Umbdenstock, president and CEO of the American Hospital Association, discussed the pending meeting during a panel at the National Business Coalition on Health's conference on Monday.

November 17, 2010 | Daily News

CMS is seeking help from physicians on ways to ensure that small physician practices can participate in Accountable Care Organizations, as physicians are likewise urging CMS to include physicians in “all practice sizes” in the new ACO models by removing resource and anti-trust barriers. The agency raised the topic on a short list of key unresolved issues for which it is seeking stakeholder input as it drafts a proposed rule on the formation of health reform-created ACOs.