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17-07-2012 | Article

More ACOs jump onto Medicare savings bandwagon


Additional information and program application

MedWire News: The Medicare Shared Savings Program has added another 89 Accountable Care Organizations (ACOs) to its ranks, the Centers for Medicare & Medicaid Services (CMS) has announced.

As the name implies, ACOs assume the financial risk and, presumably, can reap the benefits of providing care at a fixed per-patient cost.

"All ACOs that succeed in reducing the rate of growth in the cost of care while providing high-quality care may share in the savings to Medicare. To ensure high quality of care, ACOs will report performance on 33 measures relating to care coordination and patient safety, use of appropriate preventive health services, improved care for at-risk populations, and patient and caregiver experience of care," says a CMS statement.

The newly selected ACOs will be responsible for the care of close to 1.2 million Medicare beneficiaries in 40 states and the District of Columbia, bring the total number of ACOs participating in the Medicare Shared Savings Program to 154, and the total number of patients served to approximately 2.4 million.

Five of the newly enrolled ACOs have applied for a higher-risk, higher-reward version of the savings program. These organizations will share in the savings if they manage to keep costs down, but will also be liable for losses should the cost of care for their patients increase beyond their allotted amounts.

"Participation in an ACO is purely voluntary for providers. Because the Shared Savings Program is part of the original Medicare fee-for-service program, beneficiaries served by these ACOs will continue to have free choice about the care they receive and from whom they seek care, without regard to whether a particular provider or supplier is participating in an ACO," the CMS statement says.

The Shared Savings Program was created as part of the Patient Protection and Affordable Care Act. Coordinated care provided through ACOs is expected to reduce costs by ensuring that patients receive timely preventive care, diagnosis, and treatment, and by reducing duplication of services and medical errors.

By Neil Osterweil