The Centers for Medicare & Medicaid Services final rule on Medicare Shared Savings Program accountable care organizations (ACOs), published late Thursday, finalizes a proposal that calls on ACOs to describe in their applications how they will promote the use of health IT to boost care coordination.
The rule lists electronic health records, data aggregation and analytics tools, telehealth services, remote patient monitoring systems and health information exchange services as enabling technologies. However, it does not mandate any one kind of tool to be used. In February, a group of 17 organizations called the then-proposed requirement to describe plans to use technology burdensome.
"We agree that enabling technologies should be adopted thoughtfully with the goal of improving care, and not just adoption for its own sake," the rule states. "We are not finalizing additional specific requirements because we agree with commenters that ACOs should have the flexibility to define their care coordination process and use of enabling technologies. We believe this flexibility can encourage innovative methods of engaging both beneficiaries and providers in the coordination of a patient's care."
The rule adds that such flexibility is needed because of differences in the rate of IT adoption, cultural needs and health literacy of patients being served.
"As use of such technologies becomes more established, best practices may emerge in the future which CMS may consider," the rule says. "While we encourage ACO efforts to improve care coordination throughout episodes of care and during care transitions, we agree with commenters that additional requirements on providers would be burdensome."
CMS also says it will not provide waivers enabling increased reimbursement for use of telemedicine by ACOs in Track 1 of the program. Instead, it will consider such requests from ACOs in two-sided risk models, but anticipates initially limiting waivers to ACOs in Track 3 of the program; CMS says it intends to offer such a waiver "starting as early as 2017," with specific requirements to be based on the agency's efforts implementing telemedicine-based waivers in the Next Generation ACO Model.
To learn more:
- here's the rule (.pdf)