In Latest Swipe At Health Law, ACO Program That Failed To Save Government Billions Will Be Overhauled
Accountable care organizations were set up under the Affordable Care Act with the intention of improving quality and efficiency. But government data shows that they've fallen short of the savings that were projected. "After six years of experience, the time has come to put real 'accountability' in Accountable Care Organizations," CMS Administrator Seema Verma said in a statement. "Medicare cannot afford to support programs with weak incentives that do not deliver value."
The Washington Post:
Trump Administration Proposes Further Dismantling Of Affordable Care Act Through Medicare
The Trump administration is proposing to restrict an innovation in the Affordable Care Act, which was intended to improve Medicare and slow spending in the vast federal insurance system for older Americans. Health-care researchers hail the model’s promise to improve quality and efficiency, but government data suggest it is not saving enough money. The changes, announced Thursday by the administrator of the Department of Health and Human Services’ Centers for Medicare and Medicaid Services, would significantly curtail Accountable Care Organizations. The ACOs can be teams of doctors, hospitals or other providers who become responsible for all the health-care needs of a specific group of patients. (Goldstein, 8/9)
Modern Healthcare:
CMS Plans To 'Retire' Some ACOs
Currently, 460 of the 561 ACOs in the Shared Savings Program this year are in Track 1. Another eight are in Track 2, 38 are in Track 3 and 55 are in Track 1+. Over 10.5 million Medicare fee-for-service beneficiaries are in the models. The majority are in arrangements that do not take risks for increases in cost. "After six years of experience, the time has come to put real 'accountability' in Accountable Care Organizations," CMS Administrator Seema Verma said in a statement. "Medicare cannot afford to support programs with weak incentives that do not deliver value." The agency proposes that ACOs in the two years of an upside risk arrangement would get 25% rather than 50% of savings. (Dickson, 8/9)
Kaiser Health News:
Medicare To Overhaul ACOs But Critics Fear Less Participation
Medicare ACOs began in 2012 and today enroll more than 10 million beneficiaries. If they provide care for less than certain cost targets — while meeting quality of care standards — then they get to share in any of the savings. Commercial insurers and Medicaid have also adopted ACOs in the past decade. (Galewitz, 8/9)
In other health law news —
Kaiser Health News:
Podcast: KHN’s ‘What The Health?’ Coming Soon: ‘Long-Term Short-Term’ Plans
The Trump administration’s new rule allowing “short-term” insurance plans to be used for up to three years has touched off a big reaction in health policy circles. Supporters of the change say those who can no longer afford comprehensive health insurance will have the ability to purchase lesser but cheaper plans. But opponents worry that consumers who fail to read the fine print will end up with plans that won’t cover care they need. (8/9)