ACO Investment Model Launches

CMS Initiative Counts on Health IT to Enhance Care Quality, Coordination

November 04, 2014 03:33 pm News Staff

CMS recently launched a program that just might help family physicians and other health care professionals in rural and other medically underserved communities across America take better care of their patients.

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On Oct. 15, CMS Administrator Marilyn Tavenner, M.A., announced that the new initiative -- dubbed the ACO Investment Model(innovation.cms.gov) -- will provide about $114 million to as many as 75 accountable care organizations (ACOs) around the country.

The agency wants to ensure that physicians in those communities have access to enhanced care coordination through the use of health information technology (health IT) and participation in ACOs.

CMS described the millions in funding as "upfront investments."

"The ACO Investment Model will give Medicare accountable care organizations more flexibility in setting quality and financial goals while giving them greater accountability for delivering quality care efficiently," said Tavenner in a press release.(www.cms.gov)

Story Highlights
  • CMS recently announced a new initiative dubbed the ACO Investment Model.
  • The program will provide about $114 million to as many as 75 accountable care organizations (ACOs) around the country.
  • The initiative will help physicians and other health care professionals in rural and underserved areas combine health information technology resources and ACO participation to enhance the care they provide to patients.

"We are working with the organizations to make necessary investments that encourage doctors, hospitals and other health care providers to work together to better coordinate care and keep people healthy," she added.

CMS' Center for Medicare & Medicaid Innovation will oversee the initiative; participants will focus on beefing up infrastructure and redesigning health care processes so that ACOs can continue to improve the quality of care they provide.

The end goal, according to CMS, is to increase the number of Medicare patients who experience the benefits of Medicare ACOs -- such as enhanced health care and lower costs -- regardless of where they live.

ACOs that joined the Medicare Shared Savings Program(www.cms.gov) in 2012, 2013 or 2014 -- as well as new ACOs that will join in 2016 -- are eligible to apply for the funding.

Additional eligibility rules are in place for ACOs looking to participate in the new investment model. For instance, an ACO must

  • have completely and accurately reported quality measures to the Medicare Shared Savings Program in the most recent performance year,
  • have a preliminary prospective beneficiary assignment of 10,000 or fewer beneficiaries in the most recent quarter,
  • include only hospitals designated as critical-access facilities in the ACO partnership,
  • declare it is not owned or operated by a health plan, and
  • show that it did not participate in CMS' Advance Payment ACO Model.

Application deadlines for the new initiative vary according to ACOs' program participation start date. Specifically, CMS is accepting applications (login required)(innovationgov.secure.force.com) from ACOs that joined the Medicare Shared Savings Program in 2012 or 2013 through Dec. 1. ACOs that joined the shared savings program in 2014 or that intend to start in 2016 will not have access to applications until the summer of 2015.

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