CMS Coordinating with ACOs for Medicare Shared Savings Program

The Centers for Medicare & Medicaid Services (CMS) announced the availability of a new initiative for accountable care organizations (ACOs) participating in the Medicare Shared Savings Program. The new ACO Investment Model is designed to bring these efforts to better coordinate care to rural and underserved areas by providing up to $114 million in upfront investments to up to 75 ACOs across the country.   

“The ACO Investment Model will give medicare [ACOs] more flexibility in setting quality and financial goals, while giving them greater accountability for delivering quality care efficiently,” said Marilyn Tavenner, administrator, CMS, in a statement. “We are working with these 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.”  

Through the CMS Innovation Center, this initiative will provide up-front investments in infrastructure and redesigned care process to help eligible ACOs provide higher quality care. This will also help increase the number of beneficiaries that can benefit from lower costs and improved health care through Medicare ACOs. The CMS will recover these payments through an offset of an ACO’s earned shared savings.

Eligibility is targeted to ACOs who joined the Shared Savings Program in 2012, 2013, 2014, and to new ACOs joining the Shared Savings Program in 2016. The application deadline for organizations that started in the Shared Savings Program in 2012 or 2013 will be December 1, 2014. Applications will be available next summer for for ACOs that started in the Shared Savings Program in 2014 or will start in 2016.  

Recently, ACOs in the Pioneer ACO Model and the Medicare Shared Savings Program generated more than $372 million in total program savings for Medicare ACOs.

As a provision of the Patient Protection and Affordable Care Act, ACOs encourage quality improvement and care coordination through the use of health information technology. This model follows the mandate for pay-for-performance payment standards rather than the typical fee-for-services models.

Click here for more information on these new models.—Kerri Fitzgerald