CMS officials said these first 27 groups will serve about 375,000 beneficiaries in 18 states. They join another 32 groups that were approved under the Pioneer Model ACO in December, and six groups that were approved for the Physician Group Practice Transition Demonstration that began Jan. 1, 2011, for a total of 65 official ACO models to date.
Five of the 27 announced Tuesday will participate under separate rules of the Advance Payment ACO model, in which groups receive advance payments to set up the infrastructure to coordinate care for its beneficiaries.
Both the Advance Payment ACO and the Pioneer models were designed in response to intense criticism of the ACO program one year ago after the proposed rule was released. In the final rule, many of the parameters were modified, for example, the number of quality metrics reduced from 65 to 33.
Additionally, concerns about how these groups would work together and not violate anti-kickback, Federal Trade Commission and Internal Revenue Service rules were addressed with modifications to the proposed rule.
Blum said that more than half of the organizations among the latest list of 27 are groups led by physicians, which Blum said should allay fears of critics who thought that hospital organizations would dominate the ACO model.