First 27 ACOs Chosen for Medicare Shared Savings Program

April 17, 2012 05:20 pm News Staff

CMS has released the names of the first 27 accountable care organizations (ACOs)(www.cms.gov) selected to participate in CMS' Medicare Shared Savings Program(www.cms.gov).

According to an April 10 press release from CMS(www.cms.gov), the 27 ACOs have entered into contracts with the agency, agreeing to be responsible for the quality of care Medicare patients receive. In return, those ACOs have an opportunity to share in any savings realized through improved care.

The 27 organizations in the Shared Savings Program will provide care to nearly 375,000 beneficiaries in 18 states and include more than 10,000 physicians, 10 hospitals and 13 physician-driven organizations located in both urban and rural areas.

The ACOs must meet 33 quality measures established by CMS for 2012. The quality measures are intended to ensure that the savings in health care expenditures are achieved through the provision of health care that is appropriate, safe and timely. The required quality measures cover a number of topics, including

  • care coordination,
  • patient safety,
  • preventive health services,
  • care for at-risk populations, and
  • experiences reported by patients and caregivers.

CMS Acting Administrator Marilyn Tavenner, M.A., said in the press release that CMS was "encouraged by this strong start and confident that, by the end of this year, we will have a robust program in place benefiting millions of seniors and people with disabilities across the country."

This latest announcement brings the tally of organizations participating in Medicare shared savings initiatives as of April 1 to 65, after including the 32 groups participating in the Pioneer ACO Model that were announced in December 2011, as well as six organizations that are participating in the Physician Group Practice Transition Demonstration(www.cms.gov), which started in January 2011.

A CMS fact sheet(www.cms.gov) gives brief descriptions of each of the ACOs chosen and notes that five of the 27 ACOs will participate in the Advance Payment ACO Model.

Participants in this model, which was created with an eye toward rural and physician-based ACOs, will receive federal money upfront to help cover the costs of establishing the necessary infrastructure to coordinate patient care in the ACO. CMS expects ACOs to repay the advance payment from the shared savings earned. If an ACO does not meet all the necessary requirements, CMS will act to recoup the advance payment.

CMS currently is reviewing applications from more than 150 ACOs looking to participate in the next phase of the Shared Savings Program, which begins on July 1; more than 50 of these are applying for the Advance Payment ACO Model.


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