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  • Medicare Pioneer ACO Program Continues to Lose Members

    The Medicare "Pioneer" program that targets more sophisticated health systems to foster the development of accountable care organizations (ACOs) has now lost about 40% of the systems that signed on initially. According to an article in Modern Healthcare (access available via free one-time registration) the most recent withdrawals "suggest even the most sophisticated health systems may be unwilling to take losses as policymakers test new payment and delivery models."

    The most recent exits—Franciscan Alliance, Genesys PHO, and Renaissance Health Network—bring the Pioneer list from its original 32 members to 19. The Modern Healthcare article reports that 9 of the 13 ACOs that dropped out did so within the first year of the program's launch in 2012, opting instead to join the "less risky" shared savings program, the traditional Medicare program that allows other entities to form ACO. Unlike the Pioneer program, the number of entities joining the shared savings program has been steadily increasing.

    The Pioneer program was designed to help ACOs transition from a fee-for-service payment structure to improve patient care, increase Medicare savings, lower costs, and to test alternative program designs to inform future rulemaking for the Medicare Shared Savings Program. The ACOs in the Pioneer program were generally considered ones that were willing to withstand potential losses in hopes of achieving bonuses for meeting various quality and spending metrics.

    Modern Healthcare reports that while the ACO program is generally helping to set the stage for more widespread use, critics of the Pioneer program contend that Medicare's bonus formulas are "skewed in favor of [ACOs] that operate in markets that have above-average health spending, where hospitals and doctors have more opportunities for savings." The article describes how Medicare announced that its ACO initiatives saved $817 million through 2013, and how "dozens" of program participants shared in $445 million in bonuses, "but three-quarters saw nothing after failing to do sufficiently well against the financial benchmarks."

    APTA members can learn more about a physical therapist's role in an ACO by visiting APTA's webpage, FAQ: Accountable Care Organizations (ACOs): Medicare Shared Savings Program and Pioneer Models.

    November PT in Motion Cover? You Decide

    When it comes to deciding on art for PT in Motion magazine, APTA members have it covered.

    It's time once again for members to help PT in Motion magazine decide the design to be used on the cover of the upcoming issue. For November, editorial staff is proposing 2 designs and asking members to vote on their favorite cover to illustrate the concept of physical therapy across the lifespan The design that receives the most votes will be the next cover.

    Take the quick and simple survey by October 1. Just pick the design you think is likely to get you to open up the magazine, and then check out the November issue to see which cover was most popular.

    Suggestions for APTA Board, Nominating Committee Due by November 3

    As APTA continues to grow, so does its need for exceptional leaders. Anyone come to mind? Maybe you?

    The APTA Nominating Committee is seeking recommendations for the 2015 slate of candidates for elected positions. Positions open for election are Board of Directors president, vice president, and 3 directors; and 1 Nominating Committee member.

    Use the online nomination form to submit the names of qualified members who would be willing to be considered for the upcoming election cycle. Deadline is November 3.

    Now's the time. Reach out to a leader you think should take those talents to a national level for APTA, and who's ready to guide the association through some exciting years ahead.

    New Program on Early Mobilization of ICU Patients Seeks Participants

    Physical therapists have long been aware of the importance of early mobilization and rehabilitation for patients in a hospital intensive care unit (ICU). Now a new program is recruiting hospitals to participate in a project to spread that understanding by facilitating practices that can more quickly liberate patients from mechanical ventilation and move them out of the ICU.

    The Comprehensive Unit-Based Safety Program (CUSP) for Mechanically Ventilated Patients (MVP) and Ventilator Associated Pneumonia (VAP) is seeking so-called "coordinating entities" interested in participating in a 2-year program to prevent ventilator-associated events including VAP. A free 90-minute informational webinar on the program will be held on Monday, September 29, at 1:00 pm ET.

    The program focuses on improvement in staff teamwork and communication, analysis of daily process measures, efforts to mobilize patients earlier, and employment of low tidal volume ventilation strategies. Project content will be delivered through webinars, e-mail, and as online resources, and all materials are available on the CUSP 4MVP VAP project website.

    The initiative is funded by the Agency for Healthcare Research and Quality, and is being delivered in partnership with the Johns Hopkins Institute for Patient Safety and Quality, the Michigan Health and Hospital Association, the Department of Population Medicine at Harvard Medical School, and the Harvard Pilgrim Health Care Institute. APTA and its Acute Care Section provided consultation on the development of this program.

    For more information, contact the project helpdesk at cusp4mvp@jhmi.edu.