January 11, 2018

ACO roundup: Massachusetts launches first ACO certification program

Daily Briefing
    • CMS unveils new bundled payment model: Here's what you need to know. CMS on Tuesday unveiled a new voluntary bundled payment model, called Bundled Payments for Care Improvement Advanced (BPCI Advanced). Under the model, organizations can receive bundled payments for up to 32 different clinical episodes for which they will be held accountable for cost and quality. BPCI Advanced will count as an Advanced Alternative Payment Model (APM) under MACRA's Quality Payment Program. Applications open for the program on Jan. 11 and close on March 12.

    • Massachusetts establishes first US ACO certification program. In what state officials called the first U.S. program of its kind, Massachusetts has launched the ACO Certification Program, which aims to establish a statewide, all-payer set of standards for care delivery. The program, launched by the Massachusetts Health Policy Commission, certified 17 organizations—including hospitals, provider groups, and health systems—in its first round of assessments. Organizations seeking approval had to submit data on 15 measures, including patient-centered structure, population health management efforts, and prior involvement with risk-based contracts.

    • Nearly half of hospitals withdrew from CMS' voluntary bundled payment program. Just 12% of eligible hospitals enrolled in CMS' Bundled Payments for Care Improvement program, and of those, 47% stopped participating within two years of signing up, according to a new study in JAMA. Under the voluntary program, participants are responsible for certain cost and quality targets for 30-, 60-, or 90-day care episodes, earning back part of the savings if they meet those targets and reimbursing Medicare for part of the difference if they fall short of the targets. According to the researchers, the findings suggest that "for voluntary alternative payment models to have a broad effect on quality and costs of health care, barriers to participation and strategies for retention need to be addressed."

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