Another reason Republicans hate Obamacare

[ProSense]

13. Of course

"There will have a real fight on their hands depending on what this includes, 'Well, it might include things like giving an independent commission the power to ensure that Medicare only pays for procedures with real medical value; rewarding health care providers for delivering quality care rather than simply paying a fixed sum for every procedure.'

Every patient will not fit a standard algorithm. Doctors will hopefully rebel if they try too hard to act like insurance companies do and deny care that the doc on the ground deems necessary. Every family doc I know is waiting to see how this plays out."

...it'll meet resistance, especially from the insurance companies and those who put money ahead of quality care.

Will ACOs Pave the Path to Reform?

by David GornFriday, July 26, 2013

Accountable care organizations could be the linchpin of successful health care reform, according to experts at a forum last week in San Francisco.

"ACOs only take up seven pages in the uncountable number of pages in the Affordable Care Act but they are at the moment one of the fastest growing and most important elements of reform," said Wendy Everett, president of NEHI, previously known as the New England Health Institute, which sponsored the July 17 event in San Francisco.

"They're changing how health care is delivered and paid for in this country," Everett said, "and they're a vital and important part of what we're doing."

Everett said there are currently about 250 ACOs in the country, "with another 500 new groups that have submitted to be an ACO so far this year," she said.

- more -

http://www.californiahealthline.org/capitol-desk/2013/7/will-acos-pave-the-path-to-reform

More Doctors, Hospitals Partner to Coordinate Care for People with Medicare

Providers Form 106 New Accountable Care Organizations

Doctors and health care providers have formed 106 new Accountable Care Organizations (ACOs) in Medicare, ensuring as many as 4 million Medicare beneficiaries now have access to high-quality, coordinated care across the United States, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.

Doctors and health care providers can establish Accountable Care Organizations in order to work together to provide higher-quality care to their patients. Since passage of the Affordable Care Act, more than 250 Accountable Care Organizations have been established. Beneficiaries using ACOs always have the freedom to choose doctors inside or outside of the ACO. Accountable Care Organizations share with Medicare any savings generated from lowering the growth in health care costs, while meeting standards for quality of care.

“Accountable Care Organizations save money for Medicare and deliver higher-quality care to people with Medicare,” said Secretary Sebelius. “Thanks to the Affordable Care Act, more doctors and hospitals are working together to give people with Medicare the high-quality care they expect and deserve.”

ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely. The Centers for Medicare & Medicaid Services (CMS) has established 33 quality measures on care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care. Federal savings from this initiative could be up to $940 million over four years.

The new ACOs include a diverse cross-section of physician practices across the country. Roughly half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately 20 percent of ACOs include community health centers, rural health centers and critical access hospitals that serve low-income and rural communities.

The group announced today also includes 15 Advance Payment Model ACOs, physician-based or rural providers who would benefit from greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination. Medicare will recoup advance payments over time through future shared savings. In addition to these ACOs, last year CMS launched the Pioneer ACO program for large provider groups able to take greater financial responsibility for the costs and care of their patients over time. In total, Medicare’s ACO partners will serve more than 4 million beneficiaries nationwide.

Also today HHS issued a new report showing Affordable Care Act provisions are already having a substantial effect on reducing the growth rate of Medicare spending. Growth in Medicare spending per beneficiary hit historic lows during the 2010 to 2012 period, according to the report. Projections by both the Office of the Actuary at CMS and by the Congressional Budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, breaking a decades-old pattern of spending growth outstripping economic growth.

For more information on the HHS issue brief, “Growth in Medicare Spending per Beneficiary Continues to Hit Historic Lows,” visit: http://aspe.hhs.gov/health/reports/2013/medicarespendinggrowth/ib.cfm

Additional information about the Advance Payment Model is available at http://www.innovations.cms.gov/initiatives/ACO/Advance-Payment/index.html.

The next application period for organizations that wish to participate in the Shared Savings Program beginning in January 2014 is summer 2013. More information about the Shared Savings Program is available at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html?redirect=/sharedsavingsprogram/

For a list of the 106 new ACOs announced today, visit: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/News.html

http://www.hhs.gov/news/press/2013pres/01/20130110a.html