CMS News Update

The Centers for Medicare & Medicaid Services (CMS) will host two webinars about public reporting and the Physician Compare website (www.medicare.gov/physiciancompare) in October. Each webinar will offer stakeholders an opportunity to ask questions about public reporting on Physician Compare and this year’s preview period. Webinars will be conducted via WebEx at the following dates and times: Oct. 18 at 11:00 a.m. ET (8 a.m. PT) and Oct. 20 at 3 p.m. ET (12 p.m. PT). Registration can be completed by visiting Medicare’s website (www.medicare.gov).

Both sessions will present the same information. Two separate times are offered to help best accommodate schedules. During these webinars, a Physician Compare support team will present information about public reporting 2015 performance scores and the 30-day preview period, as well as address audience questions. 

Healthcare Providers Improving Quality of Care, Lowering Costs

Officials with the Centers for Medicare & Medicaid Services (CMS) recently announced 2015 performance year results for the Medicare Shared Savings Program (MSSP) and the Pioneer Accountable Care Organization (ACO) Model that show physicians, hospitals, and healthcare providers participating in ACOs continue to make significant improvements in the quality of care for Medicare beneficiaries while achieving cost savings. Collectively, Medicare ACOs have generated more than $1.29 billion in total Medicare savings since 2012, officials said.

“The coordinated, physician-led care provided by [ACOs] resulted in better care for [more than] 7.7 million Medicare beneficiaries while also reducing costs,” said Andy Slavitt, acting administrator at CMS. “I congratulate these leaders and look forward to significant growth in the program in the coming year.”

In 2015, Medicare ACOs reported a combined total program savings of $466 million, which includes all ACO experiences (392 Medicare MSSP participants and 12 Pioneer ACO participants). The results show more ACOs shared savings in 2015 compared to 2014 and those with more experience tend to perform better over time, according to CMS officials. The results are also said to show significant improvements in the quality of care providers are offering to an increasing number of Medicare beneficiaries.

ACOs are judged on their performance and their improvement on an array of metrics that assess the care they deliver. Those metrics include how highly patients rated their doctors, how well clinicians communicated, whether patients are screened for high blood pressure, and their use of electronic health records.

All 12 participants in the Pioneer ACO Model improved their quality scores from 2012-15 by more than 21 percentage points, officials said. Overall quality scores for nine of 12 Pioneer participants were more than 90% in 2015. ACOs in the Medicare MSSP also continued to show improvement, with ACOs that reported in both 2014 and 2015 improving on 84% of the quality measures that were reported in both years. Additionally, comparing 2014 and 2015 results, average quality performance improved by more than 15% on key preventive-care measures, including screening for risk of future falls, depression screening and follow up, blood pressure screening and follow up, and providing pneumonia vaccinations.

By meeting quality performance standards and their savings threshold, 125 ACOs qualified for shared-savings payments. Since the passage of the Affordable Care Act, more than 470 Medicare ACOs serving nearly 8.9 million Medicare beneficiaries have been established through the Medicare MSSP, the Pioneer ACO, the Next Generation ACO, and the Comprehensive End-Stage Renal Disease Care Model, officials said.

“[ACO] initiatives in Medicare continue to grow and achieve positive results in providing better care and health outcomes while spending taxpayer dollars more wisely,” said Patrick Conway, MD, MSc, principal deputy administrator and chief medical officer at CMS. “CMS continues to work and partner with providers across the country to improve the way healthcare is delivered in the United States.”