CHAP News Alert - HHS Announces New Incentives for Providers to Work Together Through ACOs
Oct 20, 2011
Reposed from the Centers for Medicare and Medicaid Services (CMS) Prodiver Resource Listserv
HHS Announces New Incentives for Providers to Work Together Through Accountable Care Organizations When Caring for People With Medicare
New tools help doctors and other healthcare providers improve quality of care
Thursday, October 20, 2011 – People with Medicare will be able to benefit from a new program designed to encourage primary care doctors, specialists, hospitals, and other healthcare providers to coordinate their care under a final regulation issued today by the Department of Health and Human Services (HHS). Created by the Affordable Care Act, these final rules on Accountable Care Organizations add to the menu of options for providers looking to better coordinate care for patients and will make it easier for providers to deliver high quality care and use healthcare dollars more wisely.
The initiatives announced today are just two of several efforts made possible by the Affordable Care Act to help bring better health, better care and lower costs not just to Medicare beneficiaries, but to all Americans. For example, the Bundled Payments for Care Improvement Initiative and Comprehensive Primary Care Initiative offer alternatives to coordinate and improve healthcare.
The two initiatives launched today – the Medicare Shared Savings Program and the Advance Payment model – will help providers form Accountable Care Organizations and reflect the significant input provided by stakeholders as well as lessons learned by innovators in care coordination in the private sector.
- The Medicare Shared Savings Program will provide incentives for participating healthcare providers who agree to work together and become accountable for coordinating care for patients. Providers who band together through this model and who meet certain quality standards based upon, among other measures, patient outcomes and care coordination among the provider team, may share in savings they achieve for the Medicare program. The higher the quality of care providers deliver, the more shared savings the providers may keep.
- The Advance Payment model will provide additional support to physician-owned and rural providers participating in the Medicare Shared Savings Program who also would benefit from additional start-up resources to build the necessary infrastructure, such as new staff or information technology systems. The advanced payments would be recovered from any future shared savings achieved by the Accountable Care Organization.
The Shared Savings Program final rule is posted at: http://www.ofr.gov/OFRUpload/OFRData/2011-27461_PI.pdf.
The CMS press release is available at: http://www.cms.gov/apps/media/press/release.asp?Counter=4132.
The Advanced Payment solicitation is posted at: http://innovations.CMS.gov/areas-of-focus/seamless-and-coordinated-care-models/advance-payment/.
For more information, fact sheets are posted at: http://www.HealthCare.gov/news/factsheets/2011/10/accountable-care10202011a.html and http://www.CMS.gov/ACO/.
The joint CMS and HHS Office of Inspector General (OIG) Interim Final Rule with Comment Period addressing waivers of certain fraud and abuse laws in connection with the Shared Savings Program is posted at: www.OFR.gov/inspection.aspx.
The Antitrust Policy Statement is posted at: www.FTC.gov/opp/aco/ and http://www.justice.gov/atr/public/health_care/aco.html.
The Internal Revenue Service (IRS) Fact Sheet, Tax-Exempt Organizations Participating in the Medicare Shared Savings Program through Accountable Care (FS-2001-11), will be posted at: http://www.IRS.gov.
For additional information you may view the CMS Fact Sheets (10/20) posted at: https://www.CMS.gov/apps/media/fact_sheets.asp
Federal Register Links:
ACOs: http://www.ofr.gov/OFRUpload/OFRData/2011-27461_PI.pdf
Stark Waivers: http://www.ofr.gov/OFRUpload/OFRData/2011-27460_PI.pdf
Advanced Payment: http://www.ofr.gov/OFRUpload/OFRData/2011-27458_PI.pdf