Noteworthy News

Cost of Participating in New Medicare Accountable Care Organizations Too Great

iStock_000001497717XSmallUrban safety-net hospitals having been saying it for a while now:  the cost of participating in new Medicare accountable care organizations (ACOs) is too great and the potential rewards of doing so are not commensurate with the risks.  Now, the Centers for Medicare & Medicaid Services (CMS) appears to agree – or at least to be taking such concerns seriously.  Last week, CMS issued a discussion document as sort of an addendum to its proposed regulation governing its soon-to-be-launched Medicare shared savings program.  In this document, CMS raises the possibility of establishing what it calls an “Advanced Payment ACO Initiative.”  This new program would “allow certain ACOs participating in the Medicare Shared Savings Program access to a portion of their shared savings up front, helping providers make infrastructure and staff investments crucial to successful ACOs.”  Read about CMS’s possible “Advanced Payment ACO Initiative” here.

While NAUH appreciates CMS’s recognition of the financial obstacles many hospitals face in considering participation in Medicare ACOs, we believe the agency will need to do more if it expects urban safety-net hospitals and other providers to be able to participate in the shared savings program.  NAUH will elaborate in an upcoming formal letter to CMS in response to the proposed regulation governing the ACO/Medicare shared savings program.

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