While the Centers for Medicare and Medicaid Services (CMS) continues to finalize the proposed rule on creating accountable care organizations (ACOs)--and listens to concerns from providers about their feasibility--it introduced three new initiatives Tuesday to move the accountable care process further along.
CMS said its Center for Medicare and Medicaid Innovation will be accepting applications for the first initiative--the Pioneer ACO Model--which will be available this summer for about 30 experienced organizations that are now working or considering ways to coordinate care for their patients. CMS expects this model to save Medicare about $430 million over three years.
The Pioneer initiative will require groups to work together at a "more aggressive pace" to see change--in terms of improving health outcomes and savings, said Joe McCannon, senior advisor to the CMS administrator, at a Brookings Institution presentation Tuesday on health systems improvement.
The first two years of the program will have higher levels of shared savings and higher levels or risk compared to what is outlined in the current proposed rule, he noted.
The second proposal, the Advance Payment ACO Initiative, has been introduced in response to organizations that have been worried about the capital needed to create an ACO, McCannon said. The idea is that an "advance" could be made to an organization for start-up capital investment and infrastructure costs.
"The money would be recouped through the savings that would come going forward," he said. More details need to be spelled out on how this will work. The Innovation Center is seeking public comments on this approach through June 17.
The final initiative addresses creation of four accelerated development learning sessions. The sessions will be held (beginning June 20) for healthcare providers on what steps they can take to improve care delivery and to create ways to achieve better-coordinated care.