For more information on the donut hole coverage, visit: http://www.healthcare.gov/law/features/65-older/drug-discounts/index.html

For more information on the free preventive services, visit:

http://www.healthcare.gov/law/features/65-older/medicare-preventive-services/index.html
 

1/10/13 HHS announced that under the Medicare Shared Savings Program (MSSP),a program authorized by §3022 of the ACA that helps to facilitate coordination among providers to improve the quality of care for Medicare beneficiaries, 106 Accountable Care Organizations (ACOs) have entered into agreements with CMS, as of January 1, 2013. Together, the ACOs have the potential to serve as many as 4 million people with Medicare across the United States, taking responsibility for the quality of care provided to Medicare beneficiaries in return for the opportunity to share in savings realized through improved care.

ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to the Medicare patients they serve to helps ensure that patients, especially the chronically ill, get appropriate care, with the goal of avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program. Medicare offers several ACO programs, including: 1) Medicare Shared Savings Program (for fee-for-service beneficiaries), 2) Advance Payment Model (for certain eligible providers already in or interested in the Medicare Shared Savings Program) and 3) Pioneer ACO Model (Health care organizations and providers already experienced in coordinating care for patients across care settings).

Approximately 50% of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. In addition, about 20% of all ACOs include community health centers, rural health centers and critical access hospitals that serve low-income and rural communities. To ensure that savings are achieved through improving and providing care that is appropriate, safe, and timely, an ACO must meet strict quality standards. CMS has established 33 quality measures relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and the patient and caregiver experience of care.

HHS also announced that out of the 106 new organizations, 15 of those ACOs will also be participating in the Advanced Payment Model. The Advance Payment ACO Model allows smaller physician practices and rural providers to receive some start-up funding to make important investments in their care coordination infrastructure that would later be recouped out of the entries' sharing savings. The additional 106 ACOs announced bring the total number of organizations participating in Medicare Shared Savings initiatives to over 250.

Learn more about the Advanced Payment Model at:

http://innovations.cms.gov/initiatives/aco/advance-payment/index.html