Two new changes to CMS' ACO Investment Model will help practices in rural areas gain more access to the benefits of accountable care organizations.
Two new changes to CMS’ ACO Investment Model will help practices in rural areas gain more access to the benefits of accountable care organizations (ACOs).
The modifications will allow ACOs currently participating in the Medicare Shared Savings Program to apply in the next application round, and will remove the criteria that requires rural ACOs have 10,000 or fewer assigned beneficiaries for ACOs that started in the program in 2015 (or will start in 2016).
“These two changes reflect the Innovation Center’s commitment to listening to suggestions and ensuring that demonstrations are widespread, including rural providers and smaller physician groups,” Patrick Conway, MD, deputy administrator of innovation and quality and chief medical officer of CMS, wrote in a blog post.
The ACO Investment Model will provide $114 million in upfront investments to up to 75 ACOs across the country. The model was developed to encourage new ACOs to form in rural and underserved areas. Providers in rural areas have felt it is tough for them to participate in the ACO program because of the high startup costs.
“Through the CMS Innovation Center, this initiative will provide upfront and ongoing investments in infrastructure and redesigned care process to help eligible ACOs continue to provide higher quality care,” wrote Dr Conway. “This will help increase the number of beneficiaries that can benefit from lower costs and improved health care through Medicare ACOs.”
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
Read More
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen