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The Centers for Medicare & Medicaid Services (CMS) yesterday released a final rule governing the creation of accountable care organizations (ACOs) under the Medicare Shared Savings Program. The rule made several significant changes to make the program more attractive and operationally viable. Most significantly, the rule allows all participants to share in first-dollar savings and eliminates down-side risk for low-risk ACOs participating in the track one option. The proposed rule would have subjected track one ACOs to down-side risk in the third year of the program. CMS also said it will not withhold any portion of an ACO’s earned bonus, as proposed, and eliminated indirect medical education payments from spending estimates. In addition, CMS reduced the number of quality measures to be reported to 33 from 65 and did not finalize any meaningful use requirements for the ACO program.

 

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To read CMS’ final regulation, click here.

Special Bulletin: ACO Final Rule Released (AHA Members Only)

Applications are now being accepted through November 15 for the Center for Medicare & Medicaid Innovation’s (CMMI) new Innovation Advisors Program, which seeks to train up to 200 health care leaders to test and refine new models of payment and care delivery.

 

For more information, click here.

The Medicare Payment Advisory Commission (MedPAC) recently recommended to Congress that they repeal the Sustainable Growth Rate (SGR) formula used to calculate the Physician Fee Schedule (PFS) and replace it with a 10-year path of legislated PFS updates.

 

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To read the MedPAC letter, click here.

John Nelson, MD, MHM, a hospitalist at Overlake Hospital and a Partner at Nelson Flores Hospital Medicine Consultants, believes specialty hospitalists will revolutionize inpatient care.

 

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A recent survey published in the Archives of Internal Medicine found that a majority of primary care physicians feel their patients receive too much care.

 

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Learn how Virginia Mason Medical Center and their production system, modeled after Toyota’s manufacturing principles of waste elimination, is still proving a success 10 years after its launch.

 

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