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ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
© Copyright 2018 American College of Physicians. All Rights Reserved. 190 North Independence Mall West, Philadelphia, PA 19106-1572
Toll Free: (800) 523.1546 · Local: (215) 351.2400
October 20, 2011
The American College of Physicians (ACP) today applauded CMS for
making substantial improvements in its long- awaited Final Rule on
Accountable Care Organizations (ACOs). Based on its initial,
preliminary analysis, ACP concluded that the changes will make it
easier for internal medicine physician specialists and other
primary care physicians to participate in this important effort to
improve patient care through efforts to organize an ACO or serve as
a practice in one of these efforts. Many of the changes made in
comparison to the proposed rule are consistent with comments
submitted by ACP in response to the proposed rule:
Other improvements in the ACO rule include:
Primary care physicians used for attribution can participate in
more than one ACO, rather than being limited to a single ACO under
certain conditions, and ACOs will be able to get "first dollar"
payments for achieving minimum quality thresholds.
CMS today also proposed several other initiatives to reduce
barriers to physician participation in shared savings models:
Advanced Payment Initiative: ACP commended CMS
for creating an Advanced Payment Initiative through the Innovation
Center to assist specified groups in obtaining the necessary
capital to participate in the ACO program through the receipt of
upfront front bundled payments and monthly upfront payments. These
advanced payments will be recouped from the ACO's earned shared
saving distributions, and participating ACO will not be liable to
repay Medicare if their earned shared savings do not equal the
advanced payments provided by CMS and they complete the full,
initial agreement period of their ACO involvement. This Advanced
Payment Initiative helps to recognize the problem of limited
available capital for small and medium sized physician groups
attempting to organize an ACO.
Anti-trust barriers: In addition, the
administration has offered needed guidance from the Department of
Justice and Federal Trade Commission regarding ACO participation
within the CMS Shared Saving Programs. CMS and the HHS Office of
the Inspector General also released an Interim Final Rule that
waives provisions of the Physician Self-Referral Law, the Federal
anti-kickback statute, the Civil Monetary Penalty (CMP) law
prohibiting hospital payments to physicians to reduce or limit
services (the Gainsharing CMP), and the CMP law prohibiting
inducements to beneficiaries (the Beneficiary Inducements CMP) to
ACO's approved under the Medicare Shared Savings ACO program.
Finally, ACP noted that today's release of a multi-pronged
strategy to broadly encourage adoption of the ACO shared savings
model follows on the heels of the Comprehensive Primary Care
Initiative recently announced by CMS. This bold program will create
a critical mass of payers-Medicare, private health insurers, and
Medicaid-to support and sustain primary care practices that have
transformed care and demonstrated the capability to improve care
coordination and other elements of patient-centered care.
ACP will be doing a more complete analysis of the Medicare ACO
Final rule and related releases and will have a more detailed
reaction in the near future.
The American College of Physicians (www.acponline.org) is the largest medical
specialty organization and the second-largest physician group in
the United States. ACP members include 132,000 internal medicine
physicians (internists), related subspecialists, and medical
students. Internists specialize in the prevention, detection, and
treatment of illness in adults. Follow ACP on Twitter and Facebook.
David Kinsman, (202) 261-4554, firstname.lastname@example.org
Jacquelyn Blaser, (202) 261-4572, email@example.com