More patients treated with OACs

The increase shows that more and more patients are turning to ACOs for care.

The Centers for Medicare & Medicaid Services (CMS) announced that 11 million Medicare patients will be served by care organizations responsible for the Shared Savings Program (ACO) in 2022.

According to a press release, the announcement came as part of the agency’s annual summary of the Medicare Shared Savings Program; National Medicare COA Program.

“With one in five healthcare dollars paid for by Medicare, we can strengthen and transform our healthcare system,” CMS Administrator Chiquita Brooks-LaSure said in the statement. “(ACOs) present an invaluable opportunity to move Medicare toward person-centered care.”

The statement said 66 new ACOs joined the program and 140 existing ACOs renewed their participation, bringing the total number of ACOs in the program to 483 this year. The number of Medicare patients receiving health care from a provider under an ACO Shared Savings Program increased 3%, or 324,000, from 2021.

“Over the past decade, Medicare has encouraged participation in value-based care to reward better care, smarter spending, and better outcomes,” says Meena Seshamani, MD, CMS Deputy Administrator and Center Director. for Medicare, in the statement. “CMS’ commitment to value-based care has never been stronger. As we continue to work towards our goal of increasing the number of people in a care relationship with accountability for the quality and total cost of care, we celebrate this increase in ACO participation and know that we still have work to do. to do.

ACOs have been a key innovation in moving CMS payment systems from volume-based payment to one that pays for value and results. They are held accountable for spending and quality performance. ACOs also support integrated care for Medicare beneficiaries by ensuring their physicians work as a team, the statement said.

Last year, the National Association of ACOs (NAACOS) lamented that at the end of the Trump administration, 477 ACOs participated in the program, down from a peak of 561 in 2018 and the lowest since 480. attendees of the first year of the Trump administration. in the office.

The association blames several of the Trump administration’s policies, including the 2018 “Pathway to Success” changes that allowed a limited time before ACOs began to take on financial risks and reduced the share of savings they were eligible to retain. Even with these changes, however, the Shared Savings Program ACOs still collectively care for 10.7 million Medicare patients.

Later in 2021, the Center for Medicare and Medicaid Innovation (CMMI) set a goal for every fee-for-service Medicare beneficiary to receive care from a provider who is part of an ACO by 2023.

To achieve this objective, CMMI has defined the following strategic objectives:

  • Increase the number of patients in a provider relationship that includes accountability for the quality and total cost of care, including the goal of having every Medicare fee-for-service beneficiary in an accountable care relationship. 2030.
  • Integrate health equity into all aspects of CMMI models with a greater focus on historically underserved populations. New models will include patients from these groups as well as safety net providers, and require participants to report demographics of their beneficiaries and social determinants of health.
  • Support innovations in care by enabling integrated, person-centred care, which the document defines as “the integration of the clinical needs of individuals across providers and settings, as well as meeting their social needs.” He cites behavioral health, palliative care and care for patients with complex needs as examples of areas that can be better integrated into primary care.
  • Improve access to health care by addressing affordability issues. The paper notes that while health spending growth was slower in 2010-2019 than in the previous decade, its continued rise remains unsustainable for governments and households. Therefore, “affordability is an important consideration in realizing the Innovation Center’s vision to drive broad system transformation.”
  • Align healthcare priorities and policies within CMS itself and with external stakeholders such as providers, commercial payers, states and beneficiaries with the goals of quality improvement, obtaining equitable results and reducing costs

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