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Medicare and Medicaid Demonstrations and Pilots, the CMS Innovation Center, and the Shared Savings (ACO) Program
Demonstrations are experiments that test new ways of delivering health care services, paying health care providers, or designing benefits. If these innovations prove that they can improve the Medicare and Medicaid programs, Congress and the Administration may add them to the programs. The recent health care reform law, titled the Patient Protection and Affordable Care Act ( ACA ), includes a number of new and amended and/or extended demonstration and pilot programs. One such program is the new "shared savings" program (commonly referred to as the accountable care organization or ACO program) within the Medicare Program.
The ACA also created the Centers for Medicare and Medicaid Innovation (CMMI), which is tasked with developing and funding demonstration projects to improve the quality of care for patients. CMMI launched programs such as the Pioneer ACO, Bundled Payments for Care Improvement, and the Health Care Innovation Challenge.
Center for Medicare and Medicaid Innovation (CMMI) Initiatives
A complete listing of CMMI activities can be found at the group's homepage. Below is more information on demonstrations and programs of particular interest to academic medical centers.
Accountable Care Organizations (ACOs): Medicare Shared Savings Program
CMS released the final ACO regulations on October 20, 2011. Accompanying the release of that rule was the final FTC/DOJ Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program, the CMS/OIG Final Waivers in Connection With the Shared Savings Program, and an IRS Fact Sheet, Tax-Exempt Organizations Participating in the Medicare Shared Savings Program through Accountable Care (FS-2001-11). The OIG's final waivers were issued as an interim final rule with comments; comments are due January 3, 2012.
Additional information can be found through the following:
AAMC Teleconference on the ACO Final Rule, November, 16, 2011 (Slides are available here )
Washington Highlights, April 13, 2012: CMS Announces First 27 ACOs
Washington Highlights, July 13, 2012: AAMC Members Named MSSP ACOs
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