Beyond the issue of clinical data access, Tavenner said it is still too soon for comprehensive assessments of the progress of Medicare ACOs. The agency launched the first 32 Medicare ACOs in January and aims for them and follow-on ACOs to demonstrate payment and delivery reforms that might eventually provide the basis for moving the entire Medicare program away from an episode-based care model to a comprehensive care model.
Eventually, the CMS will conduct quarterly and annual reviews of the ACO programs to assess any progress in reducing hospitalizations and the costs of care, among other measures, she said.
Also, Tavenner said her agency is considering extending the advance payment ACO model's application deadline, the last one of which was March 30, 2012. The advance payment ACO is potentially popular with physician-led groups that lack the financial resources of health systems because participating providers would receive upfront payments of the expected savings that the ACO would generate. Those providers could use the advance funding to implement some costly components needed by successful ACOs such as integrated digital record systems.
Tavenner cited the “slow uptake” on the program as driving consideration of the renewed application deadline. A decision of the extension is expected “soon.”
Similarly, the CMS is moving toward extending the deadline for the $500 million Community-based Care Transitions Program, Tavenner said. The program, part of the larger Partnership for Patients initiative, aims to reduce some of the $12 billion in annual unnecessary hospital readmissions that CMS officials have said occur in Medicare.