Sunday 9 September 2012

Medicare Savings

By Ann Carter


The Centers for Medicare & Medicaid Services (CMS) has established a Medicare Shared Savings Program (Medicare Savings Program), facilitating collaboration amongst providers. Cooperation and teamwork amongst providers developed to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and to reduce excessive costs.

The Affordable Care Act includes a number of policies to help physicians, hospitals, and other caregivers improve the safety and quality of patient care and make health care more affordable. The policies focus on the needs of patients, patient satisfaction as well as linking payments to outcomes. The guidelines and procedures will help improve the health of individuals and communities while lowering costs. Eligible providers, hospitals, and suppliers can participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO).

Through The Affordable Care Act a new Center for Medicare and Medicaid Innovations (Innovation Center) was established that will test innovative care and service delivery models. Working together with the Shared Savings Program, the CMS Innovation Center is testing an alternative ACO model, referred to as the Pioneer ACO Model. The Pioneer ACO Model is designed to support organizations with experience operating as ACOs or in similar procedures in providing more coordinated care to recipients at a lower cost to Medicare. The Pioneer ACO Model will work with organizations to test the impact of different payment arrangements to achieve the goals of providing better quality of care to patients while simultaneously reducing Medicare costs.

The CMS Innovation Center is also testing the Advance Payment ACO Model. The Advance Payment ACO Model is designed to provide additional support to physician-owned and rural providers participating in the Shared Medicare Savings Program. The Advance Payment ACO Model is specifically designed for organizations that would benefit from additional start-up resources to build the necessary infrastructure, such as hiring new staff or improving information technology systems.

The Shared Medicare Savings Program is designed to improve beneficiary outcomes and increase value of care by promoting accountability for the care of Medicare Fee for Service (FFS) beneficiaries requiring coordinated care for all services provided under Medicare FFS Encouraging investment in infrastructure and redesigned care processes. The Shared Savings Program will reward Accountable Care Organization (ACOs) that lower their growth in health care costs while meeting higher standards on quality of care with the focus being put on patients first. Being part of an ACO is purely voluntary and is available to eligible health providers and hospitals who wish to participate.




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