Robert Williams, national medical director at Deloitte Life Sciences-Healthcare Consulting, based in McLean, Va., noted "we'll start to see some early results this year with the first wave." When outcomes and savings data come in, some ACOs may need to reevaluate their direction.
"A few of those very early efforts need to stop and make a course correction and figure out how well they are executing it," Williams said. "Many of decisions (to move to accountable care) were, in a way, to experiment to get on the road and get on the onramp to build capabilities."
Designed for smaller ACOs, the Advance Payment ACO offers providers additional support with upfront investments so they can implement the necessary health IT systems and, therefore, reap the benefits sooner. Eligible ACOs do not have any inpatient facilities and have less than $50 million in total annual revenue, or are critical access hospitals and/or Medicare low-volume rural hospitals and have less than $80 million in total annual revenue.
In response to these physician-based, rural providers, CMMI announced two cohorts; one started in April and another that started in July. Together, there are 20 Advance Payment ACOs, but there will be more coming. CMS has been accepting applications for the next cohort of Advance Payment ACOs, which will start Jan. 1, 2013.
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- Coastal Medical - Providence, R.I. (serving Medicare beneficiaries in Massachusetts and Rhode Island)
- Harbor Medical Associates - South Weymouth, Mass.
- MPS ACO Physicians - Middletown, Conn.
- North Country ACO - Littleton, N.H.
- PriMed - Shelton, Conn.
- Accountable Care Partners - Jacksonville, Fla. (serving Medicare beneficiaries in Florida and Georgia)
- Coastal Carolina Quality Care - New Bern, N.C.
- Cumberland Center for Healthcare Innovation, Nashville, Tenn.
- Jackson Purchase Medical Associates - Paducah, Ky.
- Maryland Accountable Care Organization of Eastern Shore - National Harbor, Md.
- Maryland Accountable Care Organization of Western MD - National Harbor, Md. (serving Medicare beneficiaries in Maryland, Pennsylvania and West Virginia)
- Medical Mall Services of Mississippi - Jackson, Miss.
- Physicians ACO - Houston
- Primary Partners - Clermont, Fla.
- Quality Independent Physicians - Louisville, Ky. (serving Medicare beneficiaries in Indiana and Kentucky)
- Reliance Healthcare Management Solutions - Tampa, Fla.
- RGV ACO Health Providers - Donna, Texas
- St. Thomas Medical Group - Nashville, Tenn.
- Texoma ACO - Wichita Falls, Texas
- Golden Life Healthcare, Sacramento