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Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

CMS Announces New Medicare-Medicaid Accountable Care Organization Model

December 16, 2016—The Centers for Medicare and Medicaid Services (CMS) Dec. 15 announced the Medicare-Medicaid Accountable Care Organization (ACO) Model, which aims to improve care coordination for beneficiaries who are enrolled in both Medicare and Medicaid, otherwise known as dual-eligibles. 

The new ACO model builds on the current Medicare Shared Savings Program (MSSP). In current Medicare ACO initiatives, beneficiaries who are Medicare-Medicaid enrollees may be attributed to ACOs. The Medicare-Medicaid ACO Model will allow MSSP ACOs to take on accountability for the quality of care and both Medicare and Medicaid costs for Medicare-Medicaid enrollees. 

CMS is accepting letters of intent from states that wish to work with CMS to design certain state-specific elements of the model. The Medicare-Medicaid ACO Model is open to all states and the District of Columbia that have a sufficient number of Medicare-Medicaid enrollees in fee-for-service Medicare and Medicaid. 

Additionally, CMS will enter into participation agreements with up to six states with preference given to states that have low Medicare ACO saturation. Once a state is approved to participate in the model, a request for application will be released to ACOs and health care providers in that state. 

Contact:

Mary Mullaney
Director, Hospital Payment Policies
Telephone: 202-909-2084
Email: mmullaney@aamc.org

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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.


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For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org