CMS Innovation Center Announces New Models to Encourage ACO Development - May 24, 2011

The Center for Medicare and Medicaid Innovation (CMMI), part of the federal Centers for Medicare and Medicaid Services (CMS), on May 17 announced a number of new initiatives that will help physicians, hospitals and other health care providers form and expand Accountable Care Organizations (ACOs).

First, the CMMI announced it would begin accepting applications for “Pioneer ACOs” – entities with already-existing care coordination services for patients. While a number of the requirements of the Pioneer ACO Model will be consistent with or identical to those of the Medicare Shared Savings Program, the two models differ in several important respects. These differing factors include the opportunity for a more aggressive assumption of risk by the ACO, the possibility of a prospective beneficiary assignment methodology, and an expansion in the type of primary care providers serving ACO patients. More information on the Pioneer ACO Model demonstration is available online.

Second, the CMMI stated it would consider establishing an Advance Payment Initiative, which would provide new ACOs with pre-payment of shared savings to help ACOs invest in the necessary infrastructure and staff for successful care coordination. The CMMI will accept comments on its proposed Advance Payment Initiative until June 17; more information on the proposal is available on the CMMI website. Finally, the CMMI announced it will be holding four ACO Accelerated Development Learning Sessions beginning in June to educate leadership staff at new and existing ACOs about steps to improve care delivery and provide coordinated care. More information and registration for the June Accelerated Development Learning Session is also available online.