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CMS to test new ACO model for dual-eligibles

December 18, 2016
by Pamela Tabar, Editor-in-Chief
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The Centers for Medicare and Medicaid Services (CMS) is testing a new cost management model for accountable care organizations (ACOs) that will allow them to manage Medicaid costs as well as Medicare costs for their patients. The pilot is intended to carry over the models adopted under the Shared Saving Program and provide closer cost maintenance of dual-eligible beneficiaries, who often have more expensive and complex healthcare needs.

CMS hopes to engage up to six states in the initial program, with preference given to states with few existing ACOs.

“This model aims to provide improved care coordination for those enrolled in both Medicare and Medicaid, allowing providers to focus more on providing care for their patients rather than administrative work,” said Patrick Conway, MD, CMS acting principal deputy administrator, in the CMS  announcement. “CMS continues to partner with and leverage the best ideas from states to transform our health care system to improve quality and care coordination. In the long run, this partnership will result in healthier people and smarter spending.”

For more information, Read the CMS factsheet and descriptions on the Medicare-Medicaid ACO Model.

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