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ACOs Working Out Initial Difficulties

Posted in Life Sciences Investing

Apparently some early participants in the accountable care organization (ACO) program are experiencing problems accessing crucial CMS (Centers for Medicare and Medicaid Services) data.

The acting administrator of CMS has reported to ACO supervisors and others at a conference last week in D.C. that the agency is attempting to streamline access to Medicare enrollees’ data.

The CMS spokesperson averred that it is too early for any comprehensive evaluation of the first 32 Medicare ACOs, which were just launched at the beginning of the year. These ACOs and those that follow will need to show payment and delivery reforms that will, hopefully, provide the platform for restructuring the Medicare process from an episode-based care model to one of comprehensive care. CMS plans to conduct both quarterly and annual reviews of ACO programs to evaluate ongoing progress in reducing the number of hospitalizations and the cost of care, among other measures.

CMS is also considering extending the advance payment ACO model’s application deadline, the last of which was March 30. This advance payment ACO may prove especially popular with physician-led groups that do not have the financial resources of major health systems, since participating providers would receive payments upfront of the expected savings that the ACO would produce.

 

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