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CMS modifies ACO investment model to better serve rural areas

Two new revisions to CMS’ Accountable Care Organization Investment Model will afford more benefits to small practices and rural communities, according to a blog post by Patrick Conway, MD, chief medical officer of CMS.

“While we have accomplished a lot to make sure Americans have access to good, quality health care, continuing to reform our health care system by increasing quality and lowering costs will need everybody to be a part of the effort. Part of that will mean continuing important work with health care providers to reform health care delivery, efforts that have already shown promising results, including through Accountable Care Organizations,” Conway wrote.

The CMS ACO Investment Model initiative aims to allow accountable care organizations (ACOs) the ability to provide high-quality, low-cost care to more beneficiaries than ever before.

One change will allow ACOs just joining the Medicare Shared Savings Program in 2015, or are joining in 2016, to apply in the upcoming application round. The second change will adjust the eligibility criteria by removing the 10,000 or fewer assigned beneficiary eligibility requirement for rural ACOs.

Conway stated that these changes show that the Innovation Center listens to their audience and is committed to ensuring the program reaches rural providers and small physician groups. 

The model is slated to provide nearly 75 ACOs across the country with $114 million in upfront investments. Investing in care coordination, health information technology and population health platforms, the CMS hopes that a switch from reactive care to proactive care will occur in the health care system.

On July 1, 2015, ACOs that started in the Shared Savings Program in 2014-2015, or are scheduled to start in 2016, will be able to begin the application process. The second round application is now available for viewing.

 “ACOs are one part of the overall effort provided by the [ACA] to help lower costs and improve care and quality. For example, the ACA has helped to reduce hospital readmissions in Medicare by nearly eight percent between 2012 and 2013 — translating into 150,000 fewer readmissions — and quality improvements have resulted in saving 50,000 lives and $12 billion in health spending from 2010 to 2013,” Conway concluded. – by Casey Hower