CMS Initiatives Highlight New ACO Payment Model

The Centers for Medicare & Medicaid Services announced Tuesday three healthcare reform initiatives designed to facilitate the creation of Accountable Care Organizations (ACOs)—the hotly debated provider networks tasked with improving health outcomes and reducing costs.

First, the Center for Medicare and Medicaid Innovation will support a new ACO model—the “Pioneer ACO Model”—that will be available to providers this summer and is expected to save Medicare up to $430 million over three years. The Pioneer model is designed for “advanced organizations ready to participate in shared savings” and will better coordinate patient care, CMS said in a release.

“The Pioneer Model is an opportunity for those organizations that have already adopted significant care coordination processes to move further and faster into seamless, coordinated care by utilizing alternative payment mechanisms,” said Richard Gilfillan, MD, director of the Innovation Center.

In the second announced initiative, the Innovation Center is seeking comment on the idea of an “Advance Payment ACO Model” that would give certain ACOs participating in the Medicare Shared Savings Program access to their shared savings up front. CMS said this would help such providers to invest in the infrastructure and staff needed to succeed in an ACO model.

Lastly, free “Accelerated Development Learning Sessions” will become available to provider groups interested in learning how to coordinate patient care through ACOs. Four of these sessions will be held in 2011, the first of which is scheduled for June 20-22 in Minneapolis. The plenary session will be hosted via a webcast and all materials from the sessions will be publicly available.

Organizations interested in applying to the Pioneer ACO Model must submit a letter of intent on or before June 10. Applications must be received by July 18.

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