Medicare Begins Moving Health Care Providers Toward
Accountable Care Organizations
New Pioneer ACO Model could save Medicare up to $430
million over three years
May 26, 2011 When Medicare patients are given
more effective medical care it saves money for Medicare. That is a
logical deduction, since improved, healthy patients require less future
care, and one that is driving the Centers for Medicare & Medicaid
Services (CMS) to establish Accountable Care Organizations (ACOs). Three
of the first steps in this effort were announced recently.
The three initiatives announced by CMS are designed
to help doctors, hospitals and other health care providers establish
their own Accountable Care Organizations (ACOs).
Pioneer ACO Model
First, the Center for Medicare and Medicaid
Innovation (Innovation Center) will support a new ACO model that will be
available to providers this summer the Pioneer ACO Model, which
is designed for advanced organizations ready to participate in shared
savings. It is projected to save Medicare up to $430 million over three
years by better coordinating patient care.
Second, the Innovation Center is seeking comment on
the idea of an Advance Payment ACO Model that would provide
additional up-front funding to providers to support the formation of new
Accelerated Development Learning Sessions
And third, provider groups interested in learning
more about how to coordinate patient care through ACOs can attend free
new Accelerated Development Learning Sessions.
These initiatives are part of a broader effort by
the Obama Administration, made possible by the Affordable Care Act, to
improve care and lower costs.
Over and over again, we have seen that improving
how care is delivered to patients is key to reducing the growth in
health care spending, said CMS Administrator Donald M. Berwick, M.D.
When we improve the coordination of care between
providers, reduce duplication of services, and avoid medical errors, we
can get better outcomes for patients at less cost. The Affordable Care
Act has given us the tools to achieve these goals.
Implemented by the Center for Medicare and Medicaid
Innovation, these three new initiatives will help give providers new
options and incentives to participate in ACOs.
The Innovation Center has released a request for
applications (RFA) for the Pioneer ACO Model, which provides a faster
path for mature ACOs that have already begun coordinating care for
patients and are ready to move forward.
This model is designed to work in coordination with
private payers in order to achieve cost savings and improve quality
across the ACO, thus improving health outcomes and reducing costs for
Medicare beneficiaries as well as employers and other insurers.
The CMS Office of the Actuary estimates that the
care models developed through the Pioneer ACO Model could save Medicare
up to $430 million over three years.
The Pioneer Model is an opportunity for those
organizations that have already adopted significant care coordination
processes to move further and faster into seamless, coordinated care by
utilizing alternative payment mechanisms, said Richard Gilfillan, M.D.,
director of the Innovation Center.
CMS is seeking input on the idea of an Advance
Payment ACO Model, which would give certain ACOs participating in the
Medicare Shared Savings Program access to their shared savings up front,
helping them make the infrastructure and staff investments crucial to
successfully coordinating and improving care for patients.
The Innovation Center will offer new, free
Accelerated Development Learning Sessions to teach providers interested
in becoming ACOs what steps they can take to improve care delivery and
how to develop an action plan for moving toward providing better
Four Accelerated Development Learning Sessions will
be held in 2011, with the first session scheduled for June 20-22, 2011
in Minneapolis, MN. The plenary session will be available to all
interested organizations through a webcast and all materials from the
sessions will be publicly available.
These initiatives are intended to complement the
Medicare Shared Savings Program by providing additional options for ACOs.
CMS issued a proposed rule to implement the Medicare Shared Savings
Program in March 2011 and is continuing to encourage and accept comments
from providers and the public that will help strengthen the final rule.
Letter of Intent Due June 10 for Pioneer ACO Model
Organizations interested in applying to the Pioneer
ACO Model must submit a letter of intent on or before June 10, 2011.
Applications must be received on or before July 18, 2011. The Pioneer
ACO Request for Application, the Letter of Intent form and the
Application form may be accessed by
Note: The Innovation Center will hold an
Open Door Forum to review the Pioneer ACO Model Request for Application
on June 7, 2011.
More information about the Advance Payment ACO
The Innovation Center will accept comments on the
Advance Payment ACO Model, if submitted prior to June 17, 2011. Comments
should be submitted via email to:
Individuals wishing to attend the June Accelerated
Development Learning Session in person may register at
https://acoregister.rti.org. Registration is on a first come, first
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