As CMS drafts its proposed regulations for ACOs, the agency is asking when Medicare beneficiaries should be attributed to ACOs, according to a request for information from the agency.
Focusing on an issue that has rankled some hospital executives, the agency noted some people would like beneficiaries to be attributed at the start of a performance period so that the ACO "can target care coordination strategies" for them. But the agency also noted: "Others argue the attribution should occur at the end of the performance period to ensure the ACO is held accountable for care provided to beneficiaries."
In a recent interview in Becker's Hospital Review, Ron Anderson, MD, president and CEO of Parkland Health and Hospital System in Dallas and an AHA trustee, argued ACOs should identify members from the start and members should not be able to leave the ACO for a year.
The CMS request for information also asked the following:
• How should the agency assess beneficiaries' and caregiver's experience of care in ACOs?
• What patient-centeredness criteria should CMS develop for ACOs?
• What quality performance standards should HHS develop for ACOs?
• What payment models should CMS consider besides those outlined in the healthcare reform law? The law's models included shared savings and forms of capitation.
• How can CMS make sure groups of solo and small practice providers can actively participate in ACO models tested by the new Center for Medicare and Medicaid Innovation?
• Since small practices may have limited funds, what "payment models, financing mechanisms or other systems" should CMS consider? What other mechanisms could be created to provide access to capital?
Read the CMS request for information on ACOs.
Read more about planning for ACOs:
- 14 Thoughts on the Road Ahead for Hospitals With AHA Trustee Ron Anderson
- 5 Key Questions on How ACOs Will Function: From Robert Betka at Catalyst Management Advisors
- Federation of American Hospitals Answers 10 Questions on ACOs Posed by Antitrust Enforcers
Focusing on an issue that has rankled some hospital executives, the agency noted some people would like beneficiaries to be attributed at the start of a performance period so that the ACO "can target care coordination strategies" for them. But the agency also noted: "Others argue the attribution should occur at the end of the performance period to ensure the ACO is held accountable for care provided to beneficiaries."
In a recent interview in Becker's Hospital Review, Ron Anderson, MD, president and CEO of Parkland Health and Hospital System in Dallas and an AHA trustee, argued ACOs should identify members from the start and members should not be able to leave the ACO for a year.
The CMS request for information also asked the following:
• How should the agency assess beneficiaries' and caregiver's experience of care in ACOs?
• What patient-centeredness criteria should CMS develop for ACOs?
• What quality performance standards should HHS develop for ACOs?
• What payment models should CMS consider besides those outlined in the healthcare reform law? The law's models included shared savings and forms of capitation.
• How can CMS make sure groups of solo and small practice providers can actively participate in ACO models tested by the new Center for Medicare and Medicaid Innovation?
• Since small practices may have limited funds, what "payment models, financing mechanisms or other systems" should CMS consider? What other mechanisms could be created to provide access to capital?
Read the CMS request for information on ACOs.
Read more about planning for ACOs:
- 14 Thoughts on the Road Ahead for Hospitals With AHA Trustee Ron Anderson
- 5 Key Questions on How ACOs Will Function: From Robert Betka at Catalyst Management Advisors
- Federation of American Hospitals Answers 10 Questions on ACOs Posed by Antitrust Enforcers