American Society of Hematology

CMS Announces First ACOs Under the Medicare Shared Savings Program

Published on: April 12, 2012

The Centers for Medicare and Medicaid Services (CMS) announced the selection of the first 27 Accountable Care Organizations (ACOs) to participate in the Medicare Shared Saving Program. The new ACOs agreed to adhere to the quality measures set by CMS in return for the opportunity to share in potential savings realized by improved patient care.

The Shared Savings Program ACOs, which will serve an estimated 375,000 beneficiaries in 18 States, brings the total number of organizations participating in Medicare shared savings initiatives to 65. This includes the 32 Pioneer Model ACOs that were announced last December and six Physician Group Practice Transition Demonstration organizations that started in January 2011. Participation in an ACO is purely voluntary for providers and beneficiaries and people with Medicare retain their current ability to seek treatment from any provider they wish.

CMS also announced that five ACOs are participating in the Advance Payment ACO Model beginning April 1. This model will provide advance payment of expected shared savings to rural and physician-based ACOs participating in the Shared Savings Program that would benefit from additional start-up resources. These resources will help build the necessary care coordination infrastructure essential to improve patient outcomes and reduce costs, such as new staff or information technology systems. CMS is reviewing more than 50 applications for Advance Payments that start in July.

Delivery system reform experts say it is still too soon to tell whether the ACO program will be embraced by providers. When CMS unveiled the final rule in October, it projected that anywhere from 50 to 270 health systems would enroll, so even with the recent announcement, it is far short of this ball park and is beginning to draw speculation because health-care analysts do not have a lot of other ways to tell how successful the ACO program will be. Meanwhile, providers have until July to enroll in the first year of the program, and the agency says it has more than 150 applications in the pipeline.

Since the new Medicare Shared Saving Program was announced, ASH has been examining how this program will affect the practice of hematology. The Society has already provided significant feedback to CMS regarding the proposed rule and has provided ASH members with an analysis of the final rule. As ASH continues to monitor the impact the Medicare Shared Saving Program is having on hematology practices, the Society would like to know if you or any of your colleagues have contracted with an ACO. Please contact ASH Government Relations Manager Stephanie Kaplan (skaplan@hematology.org or 202-776-0544) if you and/or any of your colleagues are part of any of the newly selected ACOs.

Below please find links to several resources CMS has developed concerning ACOs and the Advanced Payment Model program:

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