CMS ‘very close’ to an­nounc­ing re­turn­ing ACOs

Modern Healthcare - - THE WEEK AHEAD - —Me­lanie Evans

The CMS is ex­pected to soon share news about ac­count­able care or­ga­ni­za­tions, the Af­ford­able Care Act’s largest test of new pay­ment mod­els that aim to im­prove care qual­ity at lower costs.

Con­tracts for the first ACOs that en­tered the Shared Sav­ings Pro­gram ex­pire at the end of De­cem­ber. Fed­eral of­fi­cials have not yet said how many of the 220 ACOs will re­turn.

Those that do come back will have new ground rules to fol­low and new op­tions to choose from. But ACOs are still wait­ing for specifics.

In June, the CMS un­veiled some changes, in­clud­ing many em­braced by ACOs. One wel­come change al­lows ACOs to avoid po­ten­tial penal­ties for an­other three years. Oth­ers praised a new op­tion for larger po­ten­tial bonuses but with the risk of larger penal­ties. But the CMS did not fi­nal­ize a few key de­tails. One area in­volves the for­mula against which the CMS mea­sures how much ACOs man­age to save, which will take ef­fect in 2017.

David Muh­lestein, Leav­itt Part­ners’ se­nior di­rec­tor of re­search and de­vel­op­ment, said the names of re­turn­ing ACOs and those elu­sive de­tails are ex­pected be­fore the new year. “We’re get­ting very close,” he said.

The CMS is also ex­pected to an­nounce an­other group of ACOs to en­ter the Shared Sav­ings Pro­gram for the first time as of Jan. 1, Muh­lestein said.

The pro­gram, which has de­liv­ered un­even sav­ings and some qual­ity gains, has ex­panded each year since its launch.

HHS has tar­geted ACOs and bun­dled pay­ments for ag­gres­sive ex­pan­sion through 2018. Medi­care will use ACOs, bun­dles and sim­i­lar pro­grams for 30% of its spend­ing by 2016 and 50% by 2018, HHS of­fi­cials an­nounced in Jan­uary.

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