This post has been contributed by Chase Matson, Manager, Government Relations, AMDR When we published last week’s blog post, Medicare ACO Rules Near Final Hurdle, we knew it would only be a matter of time before CMS released its final ACO regulations. Sure enough, only two days later, CMS officially published their long-anticipated rules, ending … Continue Reading
On Thursday, November 3rd, please join Squire, Sanders & Dempsey and Strategic Health Care for a complimentary webinar overview of the final rule recently released by the Centers for Medicare & Medicaid Services (CMS) and the opportunities it presents for Accountable Care Organizations (ACOs). As reported by the Accountable Care Forum, CMS made significant changes in … Continue Reading
On October 20, 2011, the Centers for Medicare and Medicaid Services (“CMS”) released the nearly 700-page, final rule for payments to health care providers and suppliers participating in accountable care organizations (“ACOs”) under the Medicare Shared Savings Program (“MSSP”). In response to approximately 1,320 public comments to the proposed rule, the final rule makes a number … Continue Reading
The dog days of summer may officially be behind us, but things are just starting to heat up over at the Centers for Medicare and Medicaid Services (CMS) with signs that a Medicare Shared Savings Program (MSSP) final rule could be released in the near future. This week, Modern Healthcare is reporting that the Office of … Continue Reading
The American Medical Association (AMA) recently issued its comments to CMS relating to the proposed Medicare Shared Savings Program ACO regulations. The comments cover numerous areas of the proposed regulations, and overall, the AMA makes clear its concern that the program as currently proposed provides insufficient incentives for physician participation. While acknowledging that the ACO … Continue Reading
By Daniel J. Vukelich, AMDR Earlier this week, HealthLeaders Media addressed the Top 10 Clinical Integration, ACO Physician Questions. Noting that physicians may be skeptical of new ACO arrangements, want to know how ACOs will impact their patients, and frankly how doctors will get compensated, the authors list the top ten most frequently asked questions about clinical integration (CI) and … Continue Reading
I recently co-presented a session regarding ACO’s with Tony Colarossi of Plante Moran. We presented to the Michigan Hospital Association Excellence in Governance Fellows. The audience consisted of hospital board members who participate in the fellowship program. The board members were from hospitals large and small. The audience was keenly interested in the topic and … Continue Reading
We already know our John Kirsner as a frequent speaker and blogger regarding how CMS’ Accountable Care Organization regulations would impact health care delivery. Seeing Modern Healthcare’s Joe Carlson recognize him as such is further affirmation that Squire, Sanders, & Dempsey is building on its well deserved reputation as thought leaders in the future of … Continue Reading
We love seeing our bloggers gain recognition. Today, Dan Vukelich, blogger and President/CEO of the Association of Medical Device Reprocessors offers an insightful bylined news article that headlines today’s Hospital Informer, a Fierce Healthcare news outlet distributed to 15,000 hospital management subscribers. The article offers an understanding of how the FDA-approved practice of third party reprocessing for certain … Continue Reading
The results from the five year “Group Practice Demonstration” project, which incentivized ten leading health systems if they could reduce costs by “treating older patients more efficiently while providing high-quality care,” were reported June 1 in the Washington Post. Although the article acknowledges that the test does not completely reflect the blueprint for ACOs eventually offered by CMS, … Continue Reading
At a recent briefing on ACOs, sponsored by Alliance for Health Reform and The Commonwealth Fund, a senior CMS official acknowledged what many in the provider community have been grumbling since the ACO proposed rules were released in March that the ACO program, as currently projected, sets too high a bar for participation and provides insufficient rewards … Continue Reading
By Sharon Bee Cheng, Strategic Healthcare The Center for Medicare and Medicaid Innovation (CMMI) recently unveiled the Pioneer Accountable Care Organization Model. This program is intended to complement—not replace—the ACOs developed under the Shared Savings Program (SSP) authorized in Patient Protection and Affordable Care Act. About thirty organizations will be chosen as Pioneer ACOs; letters of … Continue Reading
Last Thursday, CMS announced four free “accelerated development sessions” (ADSs). CMS describes the ADSs as “providing executives with the opportunity to learn about core functions of an Accountable Care Organization (ACO) and ways to build their organization’s capacity to succeed as an ACO. This 3-day, in-person ADS is to help new ACOs deliver better care … Continue Reading
By Sharon Bee Cheng, Strategic Healthcare Cash bonuses for ACOs will be funded by the savings they generate for the Medicare program. However, ACOs will not receive the entire portion of savings they are entitled to unless their performance on quality measures is among the best in the country. Each ACO will be measured on … Continue Reading
Following the release of the ACO regulations by CMS and the concurrent release of guidance documents from the IRS, FTC, DOJ and OIG, much of the attention of the health care industry has been focused on the practical implementation of ACOs, tax considerations, fraud and abuse concerns, improved quality of care, and the potential for … Continue Reading
By Sharon Bee Cheng, Strategic Healthcare I’m honored to be asked by the team at to offer some of our firm’s insight into what CMS is seeking in its regulations governing ACOs. CMS hopes that the formation of ACOs will prompt some reorganization of health systems, even the most integrated ones. Organizations that already substantially … Continue Reading
1:15PM—The workshop concluded a few minutes ago. Overall, I suspect that most people present or who listened or viewed the webcast would agree that the discussion was helpful and certainly many excellent points were brought forward to the regulators. Particularly in the second session, the regulators asked many probing questions, a good sign of their … Continue Reading
Yesterday, the Centers for Medicare & Medicaid Services (CMS) presented an hour-long webinar on ACOs and Antitrust, Stark Law, Anti-Kickback Statute (AKS) and Civil Monetary Penalty Law (CMP), hosted by Troy Barsky, Director, Division of Technical Payment Policy and Michael Wroblewski, Performance-Based Policy Payment Staff for CMS. Troy Barsky addressed Stark, AKS and CMP laws. … Continue Reading
A tip of the hat to David Kopans, www.accountablecareforum blogger and Squire Sanders lawyer, for his post on Fierce Healthcare’s Hospital Insider titled:”Eight Things Hospital CEOs Should Know about The ACO Regulations.” David’s analysis has the #ACO Twitter community abuzz; and it’s great our bloggers are being recognized for analysis on ACO regulation impact on … Continue Reading
CMS is on the clock first, with a free webinar titled, “ACOs and Antitrust, Stark, Anti-Kickback, & Civil Monetary Penalty Law Webinar.” Hosted by Troy Barsky, Director, Division of Technical Payment Policy at CMS and Michael Wroblewski, Performance-based Policy Payment Staff, the event is broken into two sessions this Thursday, May 5th, the first beginning … Continue Reading
We’re getting some good traction in the hospital and physician trade press regarding our analysis of the ACO regs. I provided an interview with Physicians Practice discussing the shared savings models of the proposed rules for accountable care organizations and balancing risk versus reward in establishing new health care partnerships. The interview centered on how the … Continue Reading
Providers considering applying to CMS to become an ACO should be aware that the proposed ACO rules are modeled in significant part after Medicare’s Physician Group Practice demonstration project. Five years in the planning and launched in April 2005, the PGP Demonstration included 10 multi-specialty group practices in various regions of the country comprised of … Continue Reading
The Affordable Care Act requires the assignment of Medicare beneficiaries based on which physician provides a beneficiary’s primary care services, and delegates the task of prescribing the assignment methodology to the Secretary of Health and Human Services. After considering a majority rule and a plurality rule, CMS believes that the latter should be the governing … Continue Reading
As discussed previously here, here, and here, antitrust matters are a key consideration in the design of the Shared Savings Program and ACO development. For example, antitrust review of prospective ACOs by the FTC and/or DOJ is a critical aspect of the ACO application process. Despite the release of the joint statement, there is evidence … Continue Reading