CMS selected the first 27 Accountable Care Organizations (ACO) to participate in Shared Savings Program where ACOs providing high quality care measured by 33 quality measures may share in the savings to Medicare.
The Shared Savings Program to serve an estimated 375,000 beneficiaries in 18 states brings the total organizations participating in the program to 65. This includes the 32 Pioneer Model ACOs announced last December and the six Physician Group Practice Transition Demonstration organizations started in January.
Of the 27 ACOs, five are participating in the Advance Payment ACO model an initiative developed by the CMS Innovation Center. Through the Advance Payment ACO Model, selected participants in the shared Savings Program will receive advance payments that will be repaid from the future shared savings they earn. ACOs participating will receive three types of payments to include upfront fixed payment, upfront variable payments, and varying monthly payments depending on the size of the ACO.
In April, the CMS Innovation Center selected seven geographic markets to pilot the Comprehensive Care initiative, a new multi-payer approach that aims to strengthen the primary care system with better healthcare and lower costs.
The markets were selected based on applicants that included private health plans, state Medicaid agencies, and employers that support comprehensive primary care coordination in partnership with Medicare.
The markets include:
· New Jersey—Statewide
· New York—Capital district-Hudson Valley Region
· Ohio—Cincinnati-Dayton Region
· Oklahoma—Greater Tulsa Region
Once the participating payers in each market have agreed to the terms and conditions to participate in the initiative and have a Memorandum of Understanding with CMS, the Innovation Center will provide the application for primary care practices to participate in each market. Approximately 75 primary practices will be selected to participate in each designated market.