MHA's Executive Briefing

CMS Adds More Risk to Medicare ACOs

The Centers for Medicare and Medicaid Services recently announced updates to the Medicare Accountable Care Organization (ACO) rules. According to the agency, the final rule issued “dramatically redesigns” ACOs, adding more risk and accountability, through the new Pathways to Success initiative.

More than 10.4 million beneficiaries in fee-for-service Medicare receive care from providers participating in a Medicare ACO. Most Medicare ACOs currently do not face financial consequences when costs increase, but Pathways to success changes that.

Two-thirds of providers say Medicare, Medicaid reimbursement would accelerate telemedicine plans

CMS made a series of suggestions to expand remote care in the Medicare Physician Fee Schedule and Quality Payment Program for 2019. For example, the proposal would allow physicians to practice telemedicine without establishing a prior in-person relationship with each patient. The majority of providers indicate expanded reimbursement would accelerate their plans to use telemedicine, according to a Reaction Data survey.