Despite fears about the tight timetable, the Pioneer accountable care organizations (ACOs) could launch by the end of the year, said Centers for Medicare and Medicare Services (CMS) Administrator Donald M. Berwick yesterday, reports Kaiser Health News.
With 30 Pioneers spearheading the ACO program, the later Shared Savings program still awaits the final rules to be issued from CMS before launching in January. The final CMS rules are expected to come any day now. With the compressed timetable, both proponents and critics are skeptical about when the final rules will come and how they will affect the launch of the programs.
"[T]he final rule is going to have to be digested by the prospective participants, and then there's going to be an application process to demonstrate compliance with the eligibility requirements," Jeffrey Ruggiero, a partner at Arnold & Porter, told FierceHealthcare. "Then CMS has to review those applications and offer contracts. That's an awful lot that to has to happen in a relatively short period of time."
Meanwhile, employees at Hackensack University Medical Center in New Jersey will be among the first to experience their ACO experiment, reports The Record. The pilot program between Hackensack and QualCare, the medical center's health plan, targets 13,200 people and the $47 million Hackensack spends each year on employee medical expenses, according to the article.
"It makes so much sense to start with the medical center's employee health plans, where there is more control over the benefits and incentives that could be tested before we went to market," said QualCare President and CEO Annette Catino.
In related news, health insurer Cigna and Health Choice, a physician-owned hospital organization, last week announced the launch of a "collaborative accountable care" program, Cigna's approach to ACOs. As a variation on the patient-centered medical home model, the program includes independent medical practices and a health plan. Among the key components of the program are registered nurse clinical care coordinators who help manage patients with chronic conditions and at risk for readmissions.
"We need to shift to a patient-centered system that emphasizes prevention and primary care and that rewards physicians for quality of care and improved health outcomes. That will ultimately result in a healthier population and lower medical costs," said Dr. Robert McLaughlin, Cigna's senior medical director for Tennessee, in a press release.
For more information:
- read the Kaiser brief
- read the Cigna press release
- read the Record article
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