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.