CMS Sweetens its ACO Push with New Initiatives

May 19, 2011

If you’re a physician or practice manager and you’re not so sure whether this whole ACO “sharing savings” thing will work, you’re in good company. In fact, you may be in the majority.

If you’re a physician or practice manager and you’re not so sure whether this whole ACO “sharing savings” thing will work, you’re in good company. In fact, you may be in the majority. 

This week the government - in a move experts say acknowledges that providers aren’t sold on “shared healthcare” - has literally drummed up a few new ways to try to get providers on board with shared savings. Nearly eight weeks since releasing the prosaic 429-page Accountable Care Organization rule, CMS this week unveiled three new initiatives intended will help give providers new options and incentives to participate in ACOs.

The first “initiative,” the launch of a new Center for Medicare and Medicaid Innovation (aka the “Innovation Center”), is intended to support the new “Pioneer ACO model” that will be available to providers this summer. According to CMS, the Pioneer model is designed for advanced organizations ready to participate in shared savings. It is projected to save Medicare up to $430 million over three years by better coordinating patient care.

Next up on the “initiatives” list: A formal call for comment. CMS (through the Innovation Center) said it is “seeking comment on the idea of an Advance Payment ACO Model that would provide additional up-front funding to providers to support the formation of new ACOs.”

And finally, CMS is offering free “Accelerated Development Learning Sessions” (the first one is scheduled for June 20-22 in Minneapolis) to provider groups interested in learning more about how to coordinate patient care through ACOs can attend free new.

Like many healthcare and news organizations around the country, we’re still trying to wrap our brains around these new “incentives” and what they mean for practices and their potential healthcare partners.

The one thing that is clear: CMS definitely wishes more providers were on board with its vision.

An article published by HealthLeaders Medianoted the new incentives are “in response to widespread objections from doctors and hospitals to proposed federal rules on ACOs.” Kaiser Health Newsnoted that “healthcare experts say the new program is intended to get some of the major health systems back at the ACO table. The American Medical Group Association, which represents nearly 400 large organizations, last week released a letter warning that more than 90 percent of its members would not participate because of the reporting requirements and financial disincentives.”

An article posted by Fierce Healthcare - “ACO Costs May be far higher Than Estimated” - offers somewhat of an answer as to why practices and even big hospitals might be hesitant to get their feet wet. The article highlights a letter to CMS sent by the American Hospital Association charging that the agency has underestimated ACO start-up costs to hospitals and providers.

And if big, profitable hospitals aren’t on board with CMS’ shared-savings plan, why would small practices want to buy in? Has anyone out there had a chance to see what this “Pioneer model” is all about? If so, we’d love to hear from you.

What do you think of CMS’ new ACO incentives? Post your comments below.