Spotlight on ACOs

Thirteen more accountable care organizations are participating in the Next Generation ACO model this year compared to 2017, according to CMS data.

The White House Office of Management and Budget is reviewing an interim final rule on “Addressing Extreme and Uncontrollable Circumstances” for the Medicare Shared Savings program.

The Physician-Focused Payment Technical Advisory Committee chair and vice chair asked lawmakers on Wednesday (Nov. 8) to consider letting PTAC help doctors with technical aspects of alternative pay models, giving doctors in APMs more claims data and allow for limited small-scale testing of new models.

The White House Office of Management and Budget on Thursday (Nov. 2) began reviewing a final rule that would shrink the mandatory Comprehensive Care for Joint Replacement demonstration and cancel the Episode Payment Models and Cardiac Rehabilitation incentive models.

More than half of the accountable care organizations in the Medicare Shared Savings Program reduced Medicare spending and nearly all of them scored at least 94 percent on quality measures, according to a Premier analysis of results CMS released Monday (Oct. 30).

Accountable care organizations in the Medicare Shared Savings Program and three ACO demonstrations collectively saved Medicare $70.6 million in 2016 after ACO bonuses are taken into account, a CMS spokesperson said.

Specialty doctors are lobbying Congress to exclude the cost of drugs they administer from the calculation of their Medicare bonuses and penalties because the therapies are often expensive and would result in volatile swings in reimbursement.

CMS proposed Tuesday (June 20) to exempt more doctors from the performance measures of Medicare's new physician pay rule, delay measuring doctor performance on cost, allow doctors in small and rural practices to form “virtual groups,” award bonus points to the performance scores of doctors in small practice and delay a required upgrade to physicians' electronic health record systems.

CMS told doctors in alternative pay models they all should expect 5 percent bonuses in the first year of the new pay system, which a former CMS official said comes as a relief to doctors who weren't sure they qualify for the bonus and now don't have to worry about their performance in the Merit-Based Incentive Payment System.