CMS reports wide provider participation in ACOs
Nearly 360,000 clinicians now participate in four accountable care programs serving 12.3 million Medicare or Medicaid beneficiaries, according to the Centers for Medicare and Medicaid Services.
That includes 2,893 primary care practices comprising more than 13,000 clinicians along with 54 participating insurers in the Comprehensive Primary Care Plus program, known as CPC+, under which physicians must rely heavily on information technology to be successful.
“These models demonstrate CMS’s commitment to partner with providers to improve care for patients,” says Patrick Conway, MD, acting principal deputy administrator and director of the CMS Innovation Center.
CPC+ is a payment model to incent physicians and consumers to use IT and the data it generates to improve the care of patients with serious or chronic conditions. Physician can receive higher government and private payer reimbursement based on demonstrated improvements in quality and outcomes, in addition to regular Medicare fee-for-service payments.
CPC+ may be the most ambitious payment model, with the aim of engaging physicians in fostering higher engagement with at-risk patients and families by providing 24-hour access to health information and, in some cases, medical care that includes coordination of care among provider organizations.
A second, higher level of CPC+ brings in vendors that have committed to enhancing their IT capabilities by delivering population health management tools, health information exchange services, data analytics and home-based monitoring products, along with electronic health records that support the other tools.
Also See: IT will be key to CPC+ program success
During 2017, 99 new participants and 79 renewing participants are in the Shared Savings Program, bringing the total number of clinicians up to 480 across all 50 states. A new Shared Savings model in 2018 is being designed to reduce physician financial risk, which has been a major barrier to more participation for providers, particularly small practices and rural hospitals, CMS acknowledges.
Presently, 572 accountable care organizations participate in the Shared Savings, Next Generation ACO and CEC Model programs; with another 131 ACOs in a risk-bearing track that includes these programs.