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CMS Ups the Stakes for Coordinated Care


 

Health organizations and providers experienced in providing care across multiple settings have until Aug. 19 to apply for a new accountable care organizations (ACO) program through the Centers for Medicare & Medicaid Services (CMS) that promises to offer a higher level of savings than that offered through a previous initiative.

“Hospital medicine groups in and of themselves won’t be applying for it,” says Ron Greeno, MD, MHM, chief medical officer of Brentwood, Tenn.-based Cogent HMG, and chair of SHM's Public Policy Committee. “But the groups that are looking to participate will have hospitalists working for them.”

The new program, tiled the Pioneer ACO Model, was created to offer potentially higher payments to providers and organizations who have already worked under contracts tied to shared savings or care coordination. A related model, the Medicare Shared Savings Program, does not require any previous experience with such contracts. The latter program has completed accepting public comments, but no application deadline has yet been set. (updated Aug. 15, 2011)

Just how many groups apply for the Pioneer program will be interesting: Initially, CMS will enter participation agreements with up to 30 organizations, and each must serve at least 15,000 beneficiaries (5,000 in rural areas). The capped cohort size didn’t seem to spur additional interest, as CMS originally set an application deadline for July, but pushed it back a month after providers questioned whether they were given enough time.

Still, Dr. Greeno, for one, is anxious to see the first round of applications. “It won’t interest me in terms of who jumps in,” he says. “The robustness of the response is what I’m interested in…It’s not going to do (CMS) any good to build a program nobody participates in.”

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