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ACO Concerns Elicit Enticements from CMS' Berwick

Cheryl Clark, for HealthLeaders Media, May 18, 2011

In response to widespread objections from doctors and hospitals to proposed federal rules on accountable care organizations, CMS director Don Berwick, MD, Tuesday introduced three programs designed to woo providers to apply for the new payment model.

The effort strives to "help early comers get started sooner, help novices learn faster, and help those who need a little bit of assistance to capitalize their effort," Berwick said in a news briefing.

The initiatives will allow providers "to hit the ground running," and will "give providers of all sizes and backgrounds the ability to participate in this exciting progress in American healthcare right now."

Initially however, some providers who object to the format required to set up the ACOs said Berwick had not changed their minds, and that much more work needs to be done to reduce the risk and capital outlay requirements.

1. A Fast Track for ACO Pioneers

With the first program, the Centers for Medicare & Medicaid Services is proposing to fast-track about 30 "pioneer" systems, at least to start, that already provide coordinated care. They would get a speedy way to participate in the shared savings program by September or October rather than having to waiting until Jan. 1.

The administration says that those in the pioneer model alone will save Medicare "as much as $430 million over three years by better managing care for beneficiaries and eliminating duplication."

Previously, the administration estimated three-year savings from ACO participation of between $510 million and $960 million.

The names of the 30 candidate systems were not released.

2. Accelerated Payments

In a second deal sweetener, the administration might provide some upfront payment for organizations that lack the millions of dollars in capital necessary to pay added staff and buy equipment to launch an ACO.

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