Groups Praise New ACO Model’s Expanded Telehealth Coverage

iHealthBeat, March 12, 2015

Several health IT stakeholders say technology will play a key role in CMS’ new “Next Generation Accountable Care Organization Model,” which will expand coverage of telehealth services, FierceHealthIT reports (Bowman, FierceHealthIT, 3/11).

Details of New ACO Model

According to Modern Healthcare, the new model uses a combination of fee-for-service and capitation (Evans, Modern Healthcare, 3/10). It creates four payment systems and two risk tracks for its participants, including one with almost full risk (Williams, Healthcare Dive, 3/10).

In a blog post, Patrick Conway, CMO and deputy administrator for innovation and quality at CMS, wrote that the Next Generation ACO Model “sets more predictable financial targets.” He explained, “To support increased risk, ACOs will have a stable, predictable benchmark and flexible payment options that support ACO investments in care improvement infrastructure to provide high quality care to patients” (Conway, CMS blog post, 3/10).  

In addition, he wrote that the new model “encourages greater coordination and closer care relationships between ACO providers/suppliers and beneficiaries” (FierceHealthIT, 3/11).

For example, the new model will make available several tools to bolster care management for beneficiaries. Such tools include expanded coverage of:

According to Politico‘s “Morning eHealth,” CMS plans to allow Next Generation ACOs to receive payments for telehealth services, regardless of where the patient is located (Gold et al., “Morning eHealth,” Politico, 3/12).

CMS said that it expects about 15 to 20 ACOs to participate in the new program, and it will publicly report participants’ performance on quality metrics, including patient experience ratings, on its website (CMS webpage, 3/10).