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CMS Releases New Proposal to Improve Accountable Care Organizations

The Centers for Medicare & Medicaid Services (CMS) recently released a proposal to strengthen the Shared Savings Program for accountable care organizations (ACOs) through a greater emphasis on primary care services and promoting transitions to performance-based risk arrangements. The proposed rule reflects input from program participants, experts, consumer groups, and the stakeholder community at large. CMS is seeking to continue this important dialogue to ensure that the Medicare Shared Savings Program ACOs are successful in providing seniors and people with disabilities with better care at lower costs.

CMS Administrator Marilyn Tavenner says, "This proposed rule is part of our continued commitment to rewarding value and care coordination—rather than volume and care duplication.  We look forward to partnering with providers and stakeholders to continuously refine and improve the Medicare Shared Savings program."

Through the Affordable Care Act, ACOs encourage doctors, hospitals, and other health care providers to work together to better coordinate care when people are sick and keep people healthy, which helps to reduce growth in health care costs and improve outcomes. ACOs become eligible to share savings with Medicare when they deliver that care more efficiently while meeting or exceeding performance benchmarks for quality of care.

The Shared Savings Program now includes more than 330 ACOs in 47 states, providing care to more than 4.9 million beneficiaries in Medicare fee for service. Recently, CMS announced first year Shared Savings Program (SSP) results:

Other Affordable Care Act initiatives to improve care and reduce costs have helped reduce hospital readmissions in Medicare by nearly 10% between 2007 and 2013—translating into 150,000 fewer readmissions—and quality improvements have resulted in saving 15,000 lives and $4 billion in health spending during 2011 and 2012.

CMS is seeking comment on a number of adjustments to improve the Medicare Shared Savings Program, including:

A fact sheet with more information about the proposed rule is available. The proposed rule is available for viewing and will be open to a 60-day comment period. Comments may be submitted at www.regulations.gov/.

This document is scheduled to be published in the Federal Register on 12/08/2014 and available online at http://federalregister.gov/a/2014-28388.

Source: Centers for Medicare and Medicaid