ACCOUNTABLE CARE ORGS: 2.4 Million People w/ Medicare to Receive Better, More Coordinated Care
Amidst the election spin and outright deceptions thrown around by the Romney/Ryan campaign it pays, as always, to go to a more reliable and accountable source. This is from the Centers for Medicare & Medicaid Services (7/9/2012) ~ pinto
For Immediate Release:
Monday, July 09, 2012
Contact:
CMS Office of Public Affairs
202-690-6145
HHS ANNOUNCES 88 NEW ACCOUNTABLE CARE ORGANIZATIONS
2.4 MILLION PEOPLE WITH MEDICARE TO RECEIVE BETTER, MORE COORDINATED CARE
The Centers for Medicare & Medicaid Services (CMS) announced today that as of July 1, 88 new Accountable Care Organizations (ACOs) began serving 1.2 million people with Medicare in 40 States and Washington, D.C. ACOs are organizations formed by groups of doctors and other health care providers that have agreed to work together to coordinate care for people with Medicare.
These 88 new ACOs have entered into agreements with CMS, taking responsibility for the quality of care they provide to people with Medicare in return for the opportunity to share in savings realized through high-quality, well-coordinated care.
“Better coordinated care is good for patients and it saves money,” said HHS Secretary Kathleen Sebelius. “We applaud every one of these doctors, hospitals, health centers and others for working together to ensure millions of people with Medicare get better, more patient-centered, coordinated care.”
Participation in an ACO is purely voluntary for providers. The Shared Savings Program, and other initiatives related to Accountable Care Organizations, is made possible by the 2010 Affordable Care Act. Federal savings from this initiative could be up to $940 million over four years.
“This new group of ACOs adds to a solid foundation,” said CMS Acting Administrator Marilyn Tavenner. “The Medicare ACO program opened for business in January, and already, more than 2.4 million beneficiaries are receiving care from providers participating in these important initiatives.”
The 88 ACOs announced today bring the total number of organizations participating in Medicare shared savings initiatives to 153, including the 32 ACOs participating in the testing of the Pioneer ACO Model by the Center for Medicare and Medicaid Innovation (Innovation Center) that were announced last December, and six Physician Group Practice Transition Demonstration organizations that started in January 2011. In all, as of July 1, more than 2.4 million beneficiaries are receiving care from providers participating in Medicare shared savings initiatives.
The selected ACOs operate in a wide range of areas of the country and almost half are physician-driven organizations serving fewer than 10,000 beneficiaries, demonstrating that smaller organizations are interested in operating as ACOs. Their models for coordinating care and improving quality vary in response to the needs of the beneficiaries in the areas they are serving.
To ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely, an ACO must meet quality standards. For 2012, CMS has established 33 quality measures relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care.
CMS also announced that beginning this year, new ACO applications would be accepted annually. The application period for organizations that wish to participate in the Shared Savings Program beginning in January 2013 is from August 1 through September 6, 2012. More information, including application requirements, is available at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Application.html
To learn more about the ACOs announced today, visit: http://www.cms.gov/apps/media/fact_sheets.asp
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From a patient's standpoint safety and effectiveness across multiple medical disciplines is obviously key. Many Medicare clients (disclaimer -I am one) have more than one medical situation being assessed and treated by various physicians, medical specialists, etc.
In a disjointed system the risk for an inadvertent medical mistake is higher than in a coordinated care system. Same as with any other multiple entity system. Coordinated care is also more effective - often there's a hierarchy of care needs that are best addressed in order of necessity to meet a shared goal.
And efficiency is cheaper in the fiscal picture. 
Medicare Advantage funding is basically a subsidy to insurance companies, imo. Buying coverage is voluntary on your part. It's been abused by some companies via inflated charges, lack of oversight, etc. Advantage plans offer policies to cover possible co-pays on Medicare's 80/20 payments.
There's a key word to mention when choosing health care via Medicare - Do you accept "assignment?". A yes means the provider will accept Medicare payment as a complete reimbursement. A caution, the primary provider may not speak for others involved in your care.
Choosing a coordinated care group is your choice as well. Personally, I encourage looking in to your options.
