"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Friday, April 13, 2012

27 New Medicare Accountable Care Organizations Open April 1st, 2012


A new program that will help physicians, hospitals, and other health care providers work together to improve care for people with Medicare is off to a strong start, the Centers for Medicare & Medicaid Services (CMS) announced today.

Under the new Medicare Shared Savings Program (Shared Savings Program), 27 Accountable Care Organizations (ACOs) have entered into agreements with CMS, taking responsibility for the quality of care furnished to people with Medicare in return for the opportunity to share in savings realized through improved care. The Shared Savings Program and other initiatives related to Accountable Care Organizations are made possible by the Affordable Care Act, the health care law of 2010. Participation in an ACO is purely voluntary for providers and beneficiaries and people with Medicare retain their current ability to seek treatment from any provider they wish.

The first 27 Shared Savings Program ACOs will serve an estimated 375,000 beneficiaries in 18 States. This brings the total number of organizations participating Medicare shared savings initiatives on April 1 to 65, including the 32 Pioneer Model ACOs that were announced last December, and six Physician Group Practice Transition Demonstration organizations that started in January 2011. In all, as of April 1, more than 1.1 million beneficiaries are receiving care from providers participating in Medicare shared savings initiatives.
"We are encouraged by this strong start and confident that by the end of this year, we will have a robust program in place, benefitting millions of seniors and people with disabilities across the country," said CMS Acting Administrator Marilyn Tavenner.
Anyone who has multiple doctors may have experienced the frustration of fragmented and disconnected care: lost or unavailable medical charts, trouble scheduling an appointment or talking to a doctor, duplicated medical procedures, or having to share the same information over and over with different doctors.

Accountable Care Organizations are designed to lift this burden from patients, while improving care and reducing costs. The Shared Savings Program was created by the Affordable Care Act after a number of efforts in the private sector showed that improving care can lead to lower costs. The selected ACOs include more than 10,000 physicians, 10 hospitals, and 13 smaller physician-driven organizations in both urban and rural areas. Their models for coordinating care and improving quality vary in response to the needs of the beneficiaries in the areas they are serving. CMS is reviewing more than 150 applications from ACOs seeking to enter the program in July.

To ensure that savings are achieved through improving and providing care that is appropriate, safe, and timely, an ACO must meet strict quality standards. For 2012, CMS has established 33 quality measures relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and the patient and caregiver experience of care.

CMS also announced today that five ACOs are participating in the Advance Payment ACO Model beginning April 1. This model will provide advance payment of expected shared savings to rural and physician-based ACOs participating in the Shared Savings Program that would benefit from additional start-up resources. These resources will help build the necessary care coordination infrastructure necessary to improve patient outcomes and reduce costs, such as new staff or information technology systems. CMS is reviewing more than 50 applications for Advance Payments that start in July.

  1. Accountable Care Organization/Collaborative Health Systems Partnerships
  2. Accountable Care Coalition of Caldwell County, LLC Lenoir, NC
  3. Accountable Care Coalition of Coastal Georgia Ormond, FL (Serving beneficiaries in GA and SC)
  4. Accountable Care Coalition of Eastern North Carolina, LLC New Bern, NC
  5. Accountable Care Coalition of Greater Athens Georgia Athens, GA
  6. Accountable Care Coalition of Mount Kisco, LLC Mount Kisco, NY
  7. Accountable Care Coalition of the Mississippi Gulf Coast, LLC Clearwater, FL (Serving beneficiaries in the Mississippi Gulf Coast area)
  8. Accountable Care Coalition of the North Country, LLC Canton, NY
  9. Accountable Care Coalition of Southeast Wisconsin, LLC Milwaukee, WI
  10. Accountable Care Coalition of Texas, Inc. Houston, TX
  11. AHS ACO, LLC Morristown, NJ (Serving beneficiaries in NJ and PA) AppleCare Medical ACO, LLC Buena Park, CA
  12. Arizona Connected Care, LLC Tucson, AZ
  13. Chinese Community Accountable Care Organization New York, NY
  14. CIPA Western New York IPA, doing business as Catholic Medical Partners Buffalo, NY
  15. Coastal Carolina Quality Care, Inc. New Bern, NC
  16. Crystal Run Healthcare ACO, LLC Middletown, NY (Serving beneficiaries in NY and PA)
  17. Florida Physicians Trust, LLC Winter Park, FL
  18. Hackensack Physician-Hospital Alliance ACO, LLC Hackensack, NJ (Serving beneficiaries in NJ and NY)
  19. Jackson Purchase Medical Associates, PSC Paducah, KY
  20. Jordan Community ACO Plymouth, MA
  21. North Country ACO Littleton, NH (Serving beneficiaries in NH and VT)
  22. Optimus Healthcare Partners, LLC Summit, NJ
  23. Physicians of Cape Cod ACO
  24. Premier ACO Physician Network Lakewood, CA
  25. Primary Partners, LLC Clermont, FL
  26. RGV ACO Health Providers, LLC Donna, TX
  27. West Florida ACO, LLC Trinity, FL
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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

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