ACO roundup: CMS delays effective date for mandatory Medicare bundled payments rule

Key accountable care news from the past week

This week, Vermont launches an ACO pilot program for Medicaid beneficiaries, Intermountain and Omada team up on digital diabetes prevention, and more.

  • CMS delays effective date for Medicare mandatory bundled payments rule. Citing a 60-day "regulatory freeze" imposed after President Trump's election, CMS announced Wednesday that it is delaying the effective date for new mandatory Medicare bundled payment models—but officials confirmed that the delay will not slow the launch of the initiatives. Specifically, the agency said it was delaying the effective date for models that would change provider Medicare payments for care associated with bypass surgery and heart attacks from Feb. 18 to March 21, as well as the expansion of an existing mandatory bundled payment model for certain joint replacements to include care for hip and femur fractures. However, CMS clarified that because the date falls after the 60 days in the executive order, the original launch date for the models remains in place—the only provisions that will be delayed are minor, such as small adjustments on quality scores and a new track of the comprehensive joint-replacement model that qualifies as an advanced APM under MACRA.

  • Vermont announces ACO pilot program for Medicaid beneficiaries. Vermont Gov. Phil Scott (R) last week announced that the state will launch a pilot program that will shift 30,000 of the state's Medicaid beneficiaries into an ACO. State officials contracted with OneCare Vermont to implement the ACO, under which participating hospitals will receive a fixed monthly amount from the state per Medicaid beneficiary.  The pilot program will run for one year and will cost an estimated $93 million in state and federal funding. In a statement, officials said they could expand the program if it proves successful.

  • Intermountain, Omada team up on digital diabetes pilot program. Intermountain Healthcare and Omada Health have launched a one-year pilot program that uses digital tools to prevent the onset of diabetes in at-risk patients. Intermountain and Omada Health, a digital therapeutics company, are collaborating to identify patients with prediabetes and then provide them with tools—including wireless scales and online access to lifestyle coaches—to track their weight and diet. The partnership was facilitated by the American Medical Association.

From Advisory Board:

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