Today I read a couple news stories that made me realize healthcare reform isn’t coming; it’s here. 
CMS announces 89 new ACOs Today, Health and Human Services (HHS) Secretary Kathleen Sebelius announced that 89 new Accountable Care Organizations began operating as of July 1. The new batch essentially doubles the amount of organizations that are participating in the Medicare shared savings initiatives, bringing the total to 154. “This new group of ACOs adds to a solid foundation,” said Centers for Medicare & Medicaid (CMS) Acting Administrator Marilyn Tavenner in a press release. “The Medicare ACO program opened for business in January and, already, more than 2.4 million beneficiaries are receiving care from providers participating in these important initiatives.” Starting this year, CMS will accept applications for new ACOs annually, which means the list of ACOs will likely continue to grow. From August 1 through September 6, organizations can submit applications to participate in the Medicare Shared Savings Program that begins in January 2013. For more information, visit the CMS Shared Savings Program Application page. Bundled payments save millions Today, HealthLeaders Media also published an article, “How Bundled Payments Pay Off in Joint-replacement”, which tells the story of a successful payment bundling program. Hospital officials from Baptist Health System in San Antonio, TX teamed with orthopedic surgeons and vendors to create $2 million worth of price concessions annually for joint-replacement surgeries. Baptist Health System is part of Medicare’s Acute Care Episode demonstration project. Using Medicare’s bundled payment arrangement, the hospital receives a lump sum from Medicare that covers both the hospital and physician fees. The hospital then pays the physicians their professional fee as well as an incentive payment to control costs. Successful demonstration programs typically become permanent With joint-replacement procedures expected to grow in the next 20 years, experts see the procedures as perfect candidates for bundled payment initiatives. If Baptist Health System’s experience is any indication, the potential cost savings is huge. Positive outcomes like this make it likely that the demonstration project, which is currently limited to five healthcare systems, will soon become a permanent program. CMS proposes bump to primary care providers On July 6, CMS issued a proposed rule that would give primary care providers a pay bump in 2013. Should the proposal become final, family physicians would get a 7% increase in Medicare payments, while other primary care practitioners would see a 3% to 5% increase. With the proposal, Medicare essentially puts its money where its mouth is. Primary care is expected to play a large role in many healthcare reform initiatives and it appears that CMS is planning to compensate primary care providers for their extra work. The rule also proposes that Medicare will make separate payments to primary care providers who provide assistance to patients who are transitioning to the community following a hospital stay. The proposed rule will appear in the Federal Register July 30, and CMS will accept comments until September 4, 2012. The final rule is expected before November 1, 2012. Healthcare reform is certainly upon us. Be sure to stay informed so it doesn’t pass you by.
CMS announces 89 new ACOs Today, Health and Human Services (HHS) Secretary Kathleen Sebelius announced that 89 new Accountable Care Organizations began operating as of July 1. The new batch essentially doubles the amount of organizations that are participating in the Medicare shared savings initiatives, bringing the total to 154. “This new group of ACOs adds to a solid foundation,” said Centers for Medicare & Medicaid (CMS) Acting Administrator Marilyn Tavenner in a press release. “The Medicare ACO program opened for business in January and, already, more than 2.4 million beneficiaries are receiving care from providers participating in these important initiatives.” Starting this year, CMS will accept applications for new ACOs annually, which means the list of ACOs will likely continue to grow. From August 1 through September 6, organizations can submit applications to participate in the Medicare Shared Savings Program that begins in January 2013. For more information, visit the CMS Shared Savings Program Application page. Bundled payments save millions Today, HealthLeaders Media also published an article, “How Bundled Payments Pay Off in Joint-replacement”, which tells the story of a successful payment bundling program. Hospital officials from Baptist Health System in San Antonio, TX teamed with orthopedic surgeons and vendors to create $2 million worth of price concessions annually for joint-replacement surgeries. Baptist Health System is part of Medicare’s Acute Care Episode demonstration project. Using Medicare’s bundled payment arrangement, the hospital receives a lump sum from Medicare that covers both the hospital and physician fees. The hospital then pays the physicians their professional fee as well as an incentive payment to control costs. Successful demonstration programs typically become permanent With joint-replacement procedures expected to grow in the next 20 years, experts see the procedures as perfect candidates for bundled payment initiatives. If Baptist Health System’s experience is any indication, the potential cost savings is huge. Positive outcomes like this make it likely that the demonstration project, which is currently limited to five healthcare systems, will soon become a permanent program. CMS proposes bump to primary care providers On July 6, CMS issued a proposed rule that would give primary care providers a pay bump in 2013. Should the proposal become final, family physicians would get a 7% increase in Medicare payments, while other primary care practitioners would see a 3% to 5% increase. With the proposal, Medicare essentially puts its money where its mouth is. Primary care is expected to play a large role in many healthcare reform initiatives and it appears that CMS is planning to compensate primary care providers for their extra work. The rule also proposes that Medicare will make separate payments to primary care providers who provide assistance to patients who are transitioning to the community following a hospital stay. The proposed rule will appear in the Federal Register July 30, and CMS will accept comments until September 4, 2012. The final rule is expected before November 1, 2012. Healthcare reform is certainly upon us. Be sure to stay informed so it doesn’t pass you by.
