• Thursday, April 12, 2012RSS Feed

    CMS Selects First 27 ACOs

    The Centers for Medicare and Medicaid Services (CMS) recently selected the first 27 accountable care organizations (ACOs) to participate in the Medicare Shared Saving Program (Shared Savings Program). The selected organizations have agreed to be responsible for improving care for nearly 375,000 beneficiaries in 18 states through better coordination among providers. All ACOs that succeed in providing high-quality care—per their performance on 33 quality measures while reducing the costs of care—may share in the savings to Medicare. 

    Two of the ACOs will participate in a version of the program that allows them to earn a higher share of any savings, in return for which they have agreed to be held accountable for a share of any losses if the costs of care for the beneficiaries assigned to them increase.

    Five of the 27 ACOs that are starting this month will participate in the advance payment ACO model established by the Center for Medicare and Medicaid Innovation to encourage rural and physician-based ACOs to participate in the Shared Savings Program. Under this model, each participating ACO will receive advance payments to help cover the costs of establishing the infrastructure needed to coordinate care for the beneficiaries they serve. 

    CMS currently is reviewing more than 150 applications from ACOs that are seeking to participate in the Shared Savings Program beginning July 1, of which more than 50 are applying for the advance payment ACO model.

    APTA's ACO webpage offers a variety of resources to help members determine if participation in this new model of care is a viable option for them. Resources include videos and podcasts, assessment tools, and links to summaries of ACO regulations. 


    Comments

    How will APTA assure that private practice physical therapy will not cut out of provision of physical therapy services? Won't health care systems try to keep the therapy in their system--as is now happening in Minnesota. It seems to me that many will see physical therapy as just added $$$ and when they do refer to physical therapy--they will refer back to themselves. Won't this promote decreased referral to specialists at the patients risk? What will keep ACO's from withholding referrals in order to look better (i.e. spend less money)? Who is truly looking out for the patient? We all talk about outcomes--but do our APTA leaders recognize that there are no good outcome measures currently designed to accurately measure the change in certain populations? Who is going to decide which outcome measures are valid? We need to have valid outcome standards to compare apples to apples.
    Posted by Jan H. on 6/22/2012 4:55 PM
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