CMS Announces The Addition Of More ACOs

Posted on by Frank J. Rosello

The Centers for Medicare and Medicaid Services has added 89 more accountable care organizations (ACOs) or groups of physicians and other providers working together to coordinate care and improve quality for Medicare patients in 40 states and Washington, D.C.

In return, the providers have the opportunity to share in cost savings that may result from delivering care that is patient-centered, well-coordinated and high quality.

This latest group of ACOs, which launched July 1, brings the total to 154 such organizations, which deliver care to 2.4 million Medicare beneficiaries across the nation, providing “a solid foundation,” said Marilyn Tavenner, CMS acting administrator, in a July 9 announcement. Participation in an ACO is voluntary.

ACOs rely on the use of electronic health records and other health IT to collect and share patient data to track and coordinate care. To ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely, an ACO must meet quality standards.

For 2012, CMS has established 33 quality measures relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care.

The ACO quality measures line up with those used in other CMS quality programs, such as the Physician Quality Reporting System and the Electronic Health Record (EHR) Incentive Programs.

The health reform law paved the way for the Medicare Shared Savings Program and other initiatives related to ACOs. Federal savings from this initiative could be up to $940 million over four years, according to Health and Human Services Secretary Kathleen Sebelius.

“Better coordinated care is good for patients and it saves money,” she said.

Among the 154 ACOs are the 32 groups participating in the testing of the Pioneer ACO Model by CMS’s Center for Medicare and Medicaid Innovation (Innovation Center) announced last December, and six Physician Group Practice Transition Demonstration organizations that started in January 2011.

The selected ACOs operate in a wide range of areas of the country and almost half are physician-driven organizations serving fewer than 10,000 beneficiaries, demonstrating that smaller organizations are interested in operating as ACOs, Tavenner said.

Beginning this year, CMS will accept new ACO applications annually. The application period for organizations that wish to participate in the Medicare Shared Savings Program beginning in January 2013 is from Aug. 1 through Sept. 6, 2012.

Among the 89 most recent Medicare ACOs are:

• Arizona Health Advantage, Inc., in Chandler, Ariz., comprised of networks of individual ACO practices with 73 physicians

• John Muir Physician Network, in Walnut Creek, Calif., comprised of ACO group practices and networks of individual ACO practices, with 197 physicians

• FPG Healthcare, LLC, in Orlando, Fla., comprised of ACO group practices, with 142 physicians

• Medical Mall Services of Mississippi, in Jackson, Miss., comprised of networks of individual ACO practices and a federally qualified health center, with 487 physicians

• Summa Accountable Care Organization, in Akron, Ohio, comprised of partnerships between hospitals and ACO professionals, with 612 physicians.

Article written by Mary Mosquera, Senior Editor for Government Health IT

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