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June 26, 2015 01:00 AM

CMS loosens rules for rural ACOs seeking upfront financial help

Beth Kutscher
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    The CMS is making it easier for rural healthcare providers and small physician groups to participate in Medicare accountable care organizations.

    The changes are being made to the ACO Investment Model, which provides loans to rural and underserved communities that would otherwise lack the capital to participate in the ACO program. The funds help providers set up the health information technology or data and analytics that they'll need to track and manage the health of their populations.

    A total of $114 million is expected to be awarded to about 75 ACOs to make these upfront investments.

    The two modifications to the initiative will allow ACOs already participating in the 2015 Medicare Shared Savings Program to apply in the next application round. And they remove the restriction that requires rural ACOs to have 10,000 or fewer assigned beneficiaries.

    The CMS introduced the loan program last October. The funds are paid back through deductions to any shared savings the ACOs achieve.

    Rural health providers have long felt that they were shut out of the ACO program because of the high startup costs and daunting requirements for meeting eligibility criteria.

    National Rural ACO and other groups have stepped in to assist rural health providers by creating a pooled group of hospitals that can share back-office functions like a single data warehouse.

    The changes come as the CMS has tried to increase flexibility for all interested ACO participants amid concern from providers that they're taking on too much financial risk for too little reward.

    The application process for the 2016 MSSP round begins July 1.

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        • - Value Based Care
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        • - Future of Staffing
        • - Hospital of the Future (Fall)
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