106 new ACOs formed for those on Medicare

The formation of 106 new accountable care organizations (ACOs) is providing coordinated care to 4 million Medicare beneficiaries across the United States, says U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. Since passage of the Affordable Care Act (ACA), more than 250 ACOs have been established.

ACOs "save money for Medicare and deliver higher-quality care to people with Medicare,” Sebelius says. “Thanks to the [ACA], more doctors and hospitals are working together to give people with Medicare the high-quality care they expect and deserve.”

ACOs must meet quality standards designed to help ensure that savings are achieved through improving care coordination and that provision of care that is appropriate, safe, and timely. The Centers for Medicare and Medicaid Services (CMS) has established 33 quality measures on care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care. Federal savings from this initiative could be up to $940 million over 4 years, according to the government.

The new ACOs include a diverse cross-section of physician practices across the country, according to HHS. Roughly half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately 20% of ACOs include community health centers, rural health centers and critical access hospitals that serve low-income and rural communities.

The group of 106 new ACOs also includes 15 advance payment model ACOs, physician-based or rural providers who, according to HHS, could benefit from greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination. Medicare expects to recoup advance payments over time through future shared savings. In addition to these ACOs, last year CMS launched the Pioneer ACO program for large provider groups able to take greater financial responsibility for the costs and care of their patients over time. In total, Medicare’s ACO partners will serve more than 4 million beneficiaries nationwide.

American Medical Association President Jeremy A. Lazarus, MD, says the organization "strongly advocated" for the advanced payment model ACOs.

“The AMA remains committed to ensuring that Medicare ACOs are physician-led and offers interested physicians resources to help them form an ACO, including a 'how-to' manual," he adds. “The AMA will continue to work with Congress and the administration to eliminate the broken Medicare physician payment formula and move to implement new models, such as ACOs, that can improve value for patients through better care coordination.”

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