Clinical Integration and ACO Alert 

News and Information from Broad and Cassel's Health Law Practice Group

March 2014
Volume 4, Issue 2
Practice Group Update

Fourth Annual Broad and Cassel Health Forum 


Friday, September 12, 2014

Noon - 5:30 pm

Seminole Hard Rock Hotel & Casino

Hollywood, FL


Get the most up-to-date health care information for physicians and health care executives from national and local experts in the industry.


 Registration details will be provided in the coming months.


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 Upcoming Speaking Engagements

Gabriel Imperato:
5/1-5/2, HCCA Regional Conference, San Juan, PR

Mike Segal headshot  

Mike Segal


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 Stephen Siegel  

 Stephen Siegel

Of Counsel

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Christine Burke Worthen

Of Counsel

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Heather Miller (New)  

Heather S. Miller

Senior Counsel

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  Fred Segal    

Fred Segal

To our clients and friends:


We are happy to provide you with the March 2014 issue of our ACO and Clinical Integration Alert.


Well, as discussed further below, CMS has published the cost savings performances of the 114 Medicare ACOs that went "live" in April or July, 2012.  The results are, at least in my opinion, less than stellar.  Many people thought, in forming ACOs, that there was a lot of "low hanging fruit" out there  - that if the physicians could just focus on keeping the beneficiaries away from the emergency rooms and be more careful with hospital admissions that the savings would just roll in.  Well, that didn't happen.  Clearly, reducing costs in an ACO world requires a lot of work and is not for the faint at heart.


Remember also - in the second year CMS makes it harder.   In year two the focus is not only on cost reductions, but also meeting quality measures.  In year one all an ACO needs to do is report on the 33 quality measures; in year two it is ranked on 25 of the measures.  It is unlikely that any ACO will be able to retain all of its shared savings in year two; there will likely be some diminution because of the quality measures.  In year three all 33 measures are ranked.


All of this has not slowed down the formation of new Medicare ACOs.  It remains to be seen, however, how successful this CMS project will ultimately be in the years to come.


Mike Segal

Health Law Practice Group Chair

Broad and Cassel

Adoption of Telemedicine Predicted to Grow

By: Stephen H. Siegel


Two recent analyses of the telehealth market predict substantial growth in the foreseeable future. RNCOS Business Consultancy Services is predicting a worldwide annual growth rate of 18.5%, while IHS is predicting that the telehealth market in the United States will grow from $ 240 million today to $ 1.9 billion in 2018, a 56% rate of growth.


Please click here to continue reading.  

Electronic Health Records: Present State and Future Trends

By: Christine Burke Worthen 


Since the passage of the Affordable Care Act (ACA), there has been a flurry of activity in the realm of electronic health records (EHRs). From the realization that EHRs are a vital component to effectively manage the health of a population and achieve the so-called "Triple Aim," to the journey through the myriad of requirements that need to be met to qualify for incentive payments under Meaningful Use, EHRs are front and center in the transformation from volume to value-based reimbursement.


Please click here to continue reading 

Will We Ever Move Beyond a Patch for the "Doc Fix"?

By: Heather S. Miller


Not surprising, House Speaker John Boehner announced there will be another twelve month patch for the 24% reduction in Medicare payments to physicians which is set to expire March 31st.   As expected, the House and Senate cannot agree on how to replace Medicare's sustainable growth-rate formula to compensate physicians. The bill is expected to be presented to the House on Thursday, with the Senate taking action shortly thereafter.

CMS Releases Interim Financial Results for ACOs Enrolled in the Medicare Shared Savings Program

By: Fred Segal


On January 30, 2014, the Centers for Medicare and Medicaid Services ("CMS") released interim financial results of the first contract year of its Shared Savings Program ("MSSP"). According to these results, ACOs that began the MSSP in 2012 generated $128 million in savings for Medicare, "while maintaining high quality patient care." (see CMS' blog post on the release here). CMS seems positive about the program and its future.


Please click here to read the article in full.  

 About Us
With more than 20 attorneys and a full complement of support staff, Broad and Cassel's Health Law Practice Group is intimately aware of the complex issues faced by health care providers, suppliers and consumers. 

Fundamental changes to the nation's health care delivery system are occurring at an accelerated rate, requiring those in the industry to establish and refine their practices and policies to comply with new regulations. The attorneys of our Health Law Practice Group are prepared to discuss these changes and the potential impact they will have on health care providers of all types.