Medicare Compliance & Reimbursement

Industry Note:

States Chime in with ACO Initiatives to Up the MACRA Ante

As the nation shifts to MACRA in a few short months, more states are getting involved with Accountable Care Organization (ACO) offerings, similar to one of the first Medicaid models that Minnesota originated in 2008. Many of the ideas and collaborations are being developed through the coordinated efforts of the CMS Innovation Center and states with plans for integrating ACOs to be used as future options for advanced APMs.

“Medicaid has long been a leader in supporting state innovation,” an HHS news release from Oct. 25, 2016 said. “Through existing authorities, waivers, and Innovation Center models, the federal Medicaid program is working closely to support State efforts to reform their delivery systems [to] build robust models to drive care quality and efficiency.”

Here are few of the highlights mentioned:

  • A transformation under MassHealth in Massachusetts away from FFS to provider-driven ACOs.
  • A new quality-coordinated payment and delivery system in Rhode Island.
  • “All-Payer ACO Model” in Vermont to “incentivize health care value and quality.”

Resource. To peruse the HHS news release, visit http://www.hhs.gov/about/news/2016/10/25/hhs-fact-sheet-delivery-system-reform-progress-and-future.html.