HHS Announces New Incentives for Providers to Work Together Through Accountable Care Organizations When Caring for People With Medicare
New tools help doctors and other healthcare providers improve quality of care Thursday, October 20, 2011 - People with Medicare will be able to benefit from a new program designed to encourage primary care doctors, specialists, hospitals, and other healthcare providers to coordinate their care under a final regulation issued today by the Department of Health and Human Services (HHS). Created by the Affordable Care Act, these final rules on Accountable Care Organizations add to the menu of options for providers looking to better coordinate care for patients and will make it easier for providers to deliver high quality care and use healthcare dollars more wisely. The initiatives announced today are just two of several efforts<http://www.cms.gov/aco/downloads/ACO-Menu-Of-Options.pdf> made possible by the Affordable Care Act to help bring better health, better care and lower costs not just to Medicare beneficiaries, but to all Americans. For example, the Bundled Payments for Care Improvement Initiative and Comprehensive Primary Care Initiative offer alternatives to coordinate and improve healthcare. The two initiatives launched today - the Medicare Shared Savings Program and the Advance Payment model - will help providers form Accountable Care Organizations and reflect the significant input provided by stakeholders as well as lessons learned by innovators in care coordination in the private sector. * The Medicare Shared Savings Program will provide incentives for participating healthcare providers who agree to work together and become accountable for coordinating care for patients. Providers who band together through this model and who meet certain quality standards based upon, among other measures, patient outcomes and care coordination among the provider team, may share in savings they achieve for the Medicare program. The higher the quality of care providers deliver, the more shared savings the providers may keep. * The Advance Payment model will provide additional support to physician-owned and rural providers participating in the Medicare Shared Savings Program who also would benefit from additional start-up resources to build the necessary infrastructure, such as new staff or information technology systems. The advanced payments would be recovered from any future shared savings achieved by the Accountable Care Organization. The Shared Savings Program final rule is posted at: http://www.ofr.gov/OFRUpload/OFRData/2011-27461_PI.pdf. The CMS press release is available at: http://www.cms.gov/apps/media/press/release.asp?Counter=4132. The Advanced Payment solicitation is posted at: http://innovations.CMS.gov/areas-of-focus/seamless-and-coordinated-care-models/advance-payment/. For more information, fact sheets are posted at: http://www.HealthCare.gov/news/factsheets/2011/10/accountable-care10202011a.html and http://www.CMS.gov/ACO/. The joint CMS and HHS Office of Inspector General (OIG) Interim Final Rule with Comment Period addressing waivers of certain fraud and abuse laws in connection with the Shared Savings Program is posted at: www.OFR.gov/inspection.aspx<http://www.OFR.gov/inspection.aspx>. The Antitrust Policy Statement is posted at: www.FTC.gov/opp/aco/<http://www.FTC.gov/opp/aco/> and http://www.justice.gov/atr/public/health_care/aco.html. The Internal Revenue Service (IRS) Fact Sheet, Tax-Exempt Organizations Participating in the Medicare Shared Savings Program through Accountable Care (FS-2001-11), will be posted at: http://www.IRS.gov. For additional information you may view the CMS Fact Sheets (10/20) posted at: https://www.CMS.gov/apps/media/fact_sheets.asp Federal Register Links: ACOs: http://www.ofr.gov/OFRUpload/OFRData/2011-27461_PI.pdf Stark Waivers: http://www.ofr.gov/OFRUpload/OFRData/2011-27460_PI.pdf Advanced Payment: http://www.ofr.gov/OFRUpload/OFRData/2011-27458_PI.pdf ------------------------------------------------- Vaccination is the Best Protection Against the Flu The Centers for Disease Control and Prevention is encouraging everyone 6 months of age and older to get vaccinated against the seasonal flu. The risks for complications, hospitalizations, and deaths from the flu are higher among individuals aged 65 years and older. Medicare pays for the seasonal flu vaccine and its administration for seniors and others with Medicare with no co-pay or deductible. And remember, vaccination is particularly important for healthcare workers, who may spread the flu to high-risk patients; don't forget to immunize yourself and your staff. Protect your patients. Protect your family. Protect yourself. Get the Flu Vaccination - Not the Flu. Remember - The flu vaccine plus its administration are covered Part B benefits. CMS has posted the 2011-2012 seasonal flu vaccine payment limits at http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp. Note that the flu vaccine is NOT a Part D-covered drug. For more information on coverage and billing of the flu vaccine and its administration, as well as related educational provider resources, visit http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and http://www.cms.gov/immunizations. ------------------------------------------------------ Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/ContactCMS). Thank you.
