Medicare Announces New Models For Accountable Care Programs
The announcement offers new variations in the efforts to create accountable care organizations (ACOs), which are formed by doctors, hospitals and other health care providers to coordinate patient care and lower costs. Also in the news is a look at how medical providers share information.
CMS Preps 'Next Generation' ACO Model
The CMS Innovation Center unveiled plans for a new test of accountable care with greater financial risk for hospitals and doctors but also more freedom to influence how patients seek medical care. The new program would launch in January 2016 and expand the following year to reach a total of 15 to 20 accountable care organizations, the CMS' Dr. Patrick Conway said during an Association of Health Care Journalists event Tuesday. Conway is the CMS deputy administrator for innovation and quality and its chief medical officer. The model—named by the Innovation Center as the“next generation ACO model”—will pay ACOs using a combination of capitation and fee-for-service. One option within the model will be almost full risk, Conway said. (Evans, 3/10)
Medicare Launching New ACO Program
One unique factor about the new ACO model is that beneficiaries can choose whether or not to be aligned with it, while still having free choice of providers, said Conway, who also heads the Center for Medicare and Medicaid Innovation at CMS. In addition, the model "enables [the] ACOs to provide a higher level of care coordination, and also allows us to do things like potentially lower copays -- or have no copays -- for high-value services." To become a Next Generation ACO, a provider organization must have a minimum of 10,000 beneficiaries and be willing to take on considerable financial risk. (Frieden, 3/10)
In World Of Health Data, Enemies May Become Friends
Sharing patient information is a key to improving patient health. That’s a mantra in health care these days, but it is much harder to pull off than you might think. U.S. Health and Human Services Secretary Sylvia Burwell’s recent announcement ushering in paying doctors and hospitals based more on quality than quantity makes exchanging this data more valuable by the day from a business perspective. And while there’s money to be made and customer satisfaction to be gained, many doctors say still say they aren’t getting the information they need to help their patients. (Gorenstein, 3/10)