Anesthesia Billing & Management

The first 27 accountable care organizations (ACOs) to fall under the Medicare Shared Savings Program have been chosen by the Centers for Medicare & Medicaid Services (CMS). Accountable care organizations are one of the more talked about items in healthcare reform. They are being created to bring about financial incentives for doctors, hospitals, and other healthcare providers to better coordinate care, lower their costs, and improve the health of Medicare beneficiaries.

 

Among the 27 healthcare entities in 18 states are more than 10,000 physicians, 10 hospitals, and 13 smaller physician-led entities. They are estimated to serve more than 375,000 beneficiaries. According to the CMS, this most recent ACO announcement increases the number of Medicare beneficiaries participating in various shared-savings initiatives to 1.1 million. In January, the modified Pioneer Model ACOs (32 healthcare groups) and six Physician Group Practice Transition Demonstration organizations were launched.

 

“There were some people who feared that the only entities that would participate would be hospital-dominated systems,” said Jonathan Blum, Director of the Center for Medicare at the CMS. “That has not happened.”

 

It was announced by the CMS last summer that 7 out of 10 physician groups that participated in the their Physician Group Practice Demonstration achieved benchmarks on all 32 performance measures in the fifth year of the project. However, a January Congressional Budget Office report on 10 ACOs and disease management initiatives found insufficient savings to offset cost.

 

Blum expects the new ACOs to have more success controlling healthcare costs than similar payment and delivery reform pilot projects previously authorized within Medicare. 

 

“We are encouraged by this strong start and confident that by the end of this year, we will have a robust program in place, benefitting millions of seniors and people with disabilities across the country,” said acting CMS administrator Marilyn Tavenner in a written statement.