CMS Announces Final ACO Rule

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November 04, 2011
In this issue
» New Accountable Care Guidelines Reflect ACP Concerns

» Medicare Set to Test New Model for Primary Care

» Federal Government Steps Away from Long-Term Care Program

About this newsletter

The ACP Advocate is an e-newsletter, edited by the College's Washington, DC governmental affairs division, created to provide you, our members, with succinct news about public policy issues affecting internal medicine and patient care. To learn more about ACP's Advocacy and to access the ACP Advocate archives, go to

Welcome to The ACP Advocate

I'm excited for you to read today's first story, a summary of the changes that have been made to CMS's final rule on Accountable Care Organizations.  This revised version of the rule address most of ACP's concerns with an earlier proposed rule. The revisions make it easier for internal medicine practices of all sizes to voluntary participate in ACOs and share in savings from better care coordination, reduced hospital admissions, and prevention.

Our second story today tells you more about another exciting new program, Medicare's Comprehensive Primary Care Initiative.  This initiative will enable Medicare to join with private payers and Medicaid to provide substantial and sustained support to primary care practices that are organized around the principles of a Patient-Centered Medical Home.  Although it will initially be limited to a several hundred practices in selected sites around the country, it has the potential of proving that PCMH practices, with enough support from payers, can generate quality improvements and savings. With such evidence, payers will be more likely to expand the model throughout the country.

Our last story this week lets you know about a government program that will not be moving forward.   A few weeks ago the administration announced that the CLASS Act, the piece of the Affordable Care Act that would have provided long-term care insurance, was financially unviable.  For more perspective on the announcement, check out my blog.
For more coverage of what's happening in Washington, take a look at my award-winning blog, The ACP Advocate Blog by Bob Doherty.  You can also follow me on Twitter @BobDohertyACP

And, as always, please send your feedback and suggestions on this newsletter to:

Yours truly,

Bob Doherty
Senior Vice President
Governmental Affairs and Public Policy
American College of Physicians     


In the news
» New Accountable Care Guidelines Reflect ACP Concerns
  Final rule described as less burdensome, less risky and more physician friendly

Federal health officials have released the final rule for the creation of Accountable Care Organizations, and they appear to have taken into account nearly all concerns raised by the American College of Physicians regarding earlier drafts.

The AC... » Click to read the full article

» Medicare Set to Test New Model for Primary Care
  ACP executive calls the federal program a "win-win" for physicians and patients

A federal program that promises larger Medicare payments to primary care doctors who participate in its coordinated model of care has taken a significant step forward.

The Medicare agency's Innovation Center has released details on a four-year tr... » Click to read the full article

» Federal Government Steps Away from Long-Term Care Program
  Actions raises questions, concerns about health needs of aging population

The Obama administration is abandoning one piece of the Affordable Care Act that would have established a long-term care insurance program, saying that the idea proved too costly and unworkable.

Experts say the loss of the CLASS Act — which... » Click to read the full article

In focus
Are you ready for ICD-10?
On Nov. 17, from 1:30 to 3 p.m., Eastern Time, CMS will host a conference all about ICD-10 implementation. The call, geared to physicians and other providers, will feature experts from CMS, the American Hospital Association, American Health Information Management Association and the CDC. The presentation will be followed by an opportunity for Q&A. Registration for the call is available online.

Version 5010 Deadline Looms
The Jan. 1 deadline to comply with Version 5010 electronic administrative transactions is only 115 days away. On Jan. 1 all health insurers, not just Medicare and Medicaid, will only accept electronic transactions that use the Version 5010 standards. Practices that do not successfully transition to Version 5010 will find that their claims cannot be processed – and therefore, cannot be paid. Practices need to work with the vendors, clearinghouses, and payers of their practice management systems and electronic health record to begin testing for Version 5010 compliance. Visit the CMS website at the link above for a checklist of how to get ready.

HHS Final Rule on Conflicts of Interest
HHS’s new rule on Research Conflicts of Interest eliminates the requirement that institutions post investigator conflicts on their websites. ACP’s Ethics Manualemphasizes the ethical necessity of disclosing to patients any conflict of interest, whether financial or otherwise. The absence of the website requirement presents a missed opportunity for transparency.

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