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Spotlight on ACOs

March 31, 2011 | Daily News

A broad coalition of health care stakeholders emphasized collaboration and strong, data-driven assessments in a set of “consensus” recommendations for accountable care organizations released a day before CMS was expected to unveil its long-awaited ACO rule, saying researchers should study health systems that have already produced savings and quality improvements through better coordination of care.

March 24, 2011 | Daily News

A group of Democratic senators continues to press the administration to give the Department of Justice a role in antitrust enforcement of accountable care organizations, with a private antitrust lawyer suggesting DOJ is seen as more likely than the Federal Trade Commission to allow hospital mergers that would make ACOs a powerful force in integrating health care. The lawyer said the White House has more control over DOJ so Democrats might want to give DOJ a shared role with FTC because ACOs are viewed as a key health reform tool to reduce costs and improve health care quality.

March 11, 2011 | Daily News

CMS' long-awaited proposed rule on accountable care organizations will be released within the next two weeks, HHS Secretary Kathleen Sebelius said Thursday (March 10) following a House appropriations hearing. The rule was initially scheduled to be released late last year, but has been delayed multiple times to ensure that CMS “gets it right,” CMS Administrator Don Berwick told insurers earlier this week.

When later asked about Sebelius' statement, an HHS spokesperson said the rule would come out “sometime within the next few weeks.”

February 24, 2011 | Daily News

CMS appears to have punted key decisions regarding anti-fraud waivers associated with creation of health reform's accountable care organizations, and has signaled to stakeholders it may also put off a final decision on whether the Justice Department or Federal Trade Commission should oversee ACO anti-trust concerns, as it prepares to issue a long-awaited ACO rule in the next several days.

February 23, 2011 | Daily News

The Office of Management and Budget is reviewing the highly anticipated health reform law's rule on Accountable Care Organizations, a last step before the proposed rule's release. The rule, which was originally expected to be released late last year before being delayed until mid-January and again until later this month, went to OMB on Feb. 14. There is still no scheduled date for the rule's release.

February 11, 2011 | Daily News

The U.S. Chamber of Commerce recently sent a private letter to CMS Administrator Donald Berwick raising concerns that providers will shift costs onto private insurers and employers insurance as an untended result of Accountable Care Organizations (ACO), a central piece of delivery system reform in the health care law and regulations for which could come out by the end of this month.

February 11, 2011 | Daily News

Utah Republican Gov. Gary Herbert, a staunch opponent of the new health reform law, came to Washington on Thursday to offer priorities for reforming Medicaid, including a stronger focus on accountable care organization and increased use of technology in state Medicaid programs.

February 10, 2011 | Daily News

CMS is considering using CMMI funding to help physician practices develop their own accountable care organizations, CMS' Jonathan Blum said during an American Medical Association forum today. It's not a done deal but the suggestion is being considered, Blum said. He also said that CMS officials understand the providers need to have real time Medicare data sharing, but noted that such information has historically been kept private, so data sharing is a key issue officials are weighing.

February 09, 2011 | Daily News

As CMS gets closer to issuing its much-anticipated proposed rule on health reform's Accountable Care Organizations (ACO), increasingly more attention is being given to the idea of states promoting ACOs and incorporating Medicaid into the model.

February 02, 2011 | Daily News

CMS Administrator Donald Berwick indicated Tuesday that CMS still plans to let accountable care organizations include Medicare beneficiaries and patients with private insurance. Specifically, he said the CMS innovation center will make room for the "vanguards" of accountable care organizations so CMS can test ACO models that go beyond what is called for under the ACO program.

January 27, 2011 | Daily News

Key administration officials will discuss their goals for creating the health reform law's Accountable Care Organizations at a Feb. 1 public meeting hosted by the Brookings Institution, an event likely to be heavily attended by stakeholders who are anxiously awaiting upcoming CMS regulations on the issue. CMS Administrator Donald Berwick will discuss “goals” for ACOs and Nancy-Ann DeParle, counselor to president and director of the White House Office of Health Reform, will discuss “advancing accountable care together,” the agenda states.

January 24, 2011 | Daily News

The White House plans to hold a briefing soon to discuss accountable care organizations and also plans to tout its efforts to stem hospital-acquired conditions, sources say. Patient safety initiatives, including curbing hospital-acquired conditions, could be incubators for larger reforms that aim to improve care and reduce costs, sources say. Washington insiders say behind-the-scenes discussions regarding ACO options have increased in the past few weeks.

January 22, 2011 | Daily News

The White House held discussions with stakeholders last year about the possibility of CMS assigning Medicare and possibly Medicaid beneficiaries to existing clinically integrated entities in the private insurance market, which many consider the equivalent to what will be accountable care organizations (ACOs), but an expected post-election announcement never occurred. Stakeholders say it’s no longer clear whether CMS will move on the policy any time soon or whether the idea will be broached at a White House ACO briefing expected to take place next week (see story).

January 22, 2011 | Daily News

Providers in the physician group practice demonstrations are urging CMS to loosen the cost-cutting threshold as they negotiate the next round of PGP demonstrations, arguing that it is too difficult to continue reducing costs by more than 2 percent after five years of lowering costs, sources say. CMS is expected to let the PGPs apply to become accountable care organizations once the ACO program is running, which is supposed to be next year, even though the PGP demonstrations will run for three years.

January 22, 2011 | Daily News

People should know they are in accountable care organizations and they should be allowed to opt out of them, even though those who don't opt out are not required to use doctors in the ACO network, Premier is telling CMS. In return, a Premier source says, CMS should let ACOs market to beneficiaries once they've opted in, as part of a bid to keep patients in network, and should be allowed to monitor the care of patients in ACOs.

January 07, 2011 | Daily News

Three groups are sharing their accountable care organization models as a way to inspire other ACO groups across the country that are forming in advance of CMS' final rule governing how the groups will operate. The three groups published their approaches in Thursday's issue of Health Affairs, focusing on collaboration between providers and insurers, flexibility and accountability in care.

January 03, 2011 | Daily News

Pharmacies are urging CMS to require that accountable care organizations use medication therapy management -- a service that pharmacists provide -- as a way to recognize pharmacies in ACOs. The health reform law allows hospitals and doctors to share savings under Part A and Part B, but shared-savings schemes do not apply to the drug benefit (Part D) so ACOs would have to agree to share savings with pharmacies through contract or employment arrangements with pharmacists, a pharmacist source says.

December 30, 2010 | Daily News

The implementation of accountable care organizations and the expansion of information technology will be among the issues facing the health reform industry in 2011 as the implementation of the new law moves forward, according to a PricewaterhouseCoopers Health Research Institute report.

December 28, 2010 | Daily News

Physician advocates are urging CMS to use already established principles for creating accountable care organizations as a basis for forming the patient-centeredness criteria of the upcoming ACO regulation. CMS solicited stakeholder comments earlier this month to help guide staff as they craft the much-anticipated regulations defining an ACO, which are expected to be released in January.

In the call for comments, CMS asked stakeholder the following: “What aspects of patient-centeredness are particularly important for us to consider.”

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