Medicare's Vision for Delivery-System Reform — The Role of ACOs

• Published in: The New England journal of medicine Vol. 373; no. 11; pp. 987 - 990
• Main Authors: Pham, Hoangmai H, Pilotte, John, Rajkumar, Rahul, Richter, Elizabeth, Cavanaugh, Sean, Conway, Patrick H
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 10.09.2015
• Subjects: Accountable care organizations; Accountable Care Organizations - organization & administration; Accountable Care Organizations - trends; Centers for Medicare and Medicaid Services (U.S.); Delivery of Health Care - organization & administration; Electronic health records; Health Care Reform; Humans; Medicaid; Medicare; Medicare - organization & administration; Reforms; United States; United States
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMp1507319

Accountable care organizations could be central to Medicare's strategy for delivery-system reform. To further improve ACOs, the Centers for Medicare and Medicaid Services is applying the lessons it's been learning from its ACO initiatives over the past 5 years. Earlier this year, the Department of Health and Human Services announced the goals of tying 30% of Medicare payments to alternative payment models by the end of 2016 and 50% by the end of 2018. 1 That move was reinforced by the Medicare Access and CHIP Reauthorization Act of 2015, which replaced the sustainable growth rate formula for calculating physician payments with a Merit-based Incentive Payment System (MIPS) that consolidates and incorporates key components of the Physician Quality Reporting System, the Physician Value-Based Payment Modifier, and the Medicare Electronic Health Records Incentive program for eligible professionals. The MIPS will adjust payment . . .