Friday, May 4, 2012

First ACOs announced under ACA Shared Savings Program

Twenty-seven Accountable Care Organizations (ACOs) in 18 states have entered into voluntary agreements with CMS under the new Medicare Shared Savings Program established under the Affordable Care Act. Under the Shared Savings Program, these ACOs have agreed to take responsibility for improving the health and experience of care for individuals and improving the health of populations while reducing the rate of growth in health care spending. These selected ACOs include more than 10,000 physicians, 10 hospitals, and 13 smaller physician-driven organizations in both urban and rural areas and will serve an estimated 375,000 Medicare beneficiaries.
These ACOs must meet strict quality standards to ensure that savings are achieved through improving and providing care that is appropriate, safe, and timely. 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 the patient and caregiver experience of care. Their models for coordinating care and improving quality must be responsive to the needs of the beneficiaries in the areas they are serving.
Shared savings program. Section 3022 of the ACA added a new Section 1899  to the Social Security Act that required the Secretary of HHS to establish the Shared Savings Program.
These 27 ACOs will bring the total number of organizations participating in Medicare shared savings initiatives to 65 as of April 1, 2012, including the 32 Pioneer Model ACOs that were announced in December 2011, and six Physician Group Practice Transition Demonstration organizations that started in January 2011. In all, under these initiatives, more than 1.1 million beneficiaries will receive care from providers participating in Medicare shared savings initiatives. CMS also is reviewing more than 150 applications from ACOs seeking to enter the program in July.
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