CMS names first ACOs approved
for the Medicare Shared Savings Program

posted 04.26.12

Twenty-seven accountable care organizations, or ACOs, have been approved by the Centers for Medicare and Medicaid Services to participate in the Medicare Shared Savings Program. Two are in Texas: Accountable Care Coalition of Texas, Inc. in Houston, and RGV ACO Health Providers, LLC in Donna, between McAllen and Harlingen.

“The selected organizations have agreed to be responsible for improving care for nearly 375,000 beneficiaries in eighteen states through better coordination among providers,” CMS said in a press release. “All ACOs that succeed in providing high quality care—as measured by performance on 33 quality measures relating to care coordination and patient safety, use of appropriate preventive health services, improved care for at-risk populations, and the patient experience of care—while reducing the costs of care—may share in the savings to Medicare.”

The Accountable Care Coalition of Texas is a partnership between independent physician associations, medical groups, and health systems in the Houston/Beaumont area of Texas. The ACO is expected to serve nearly 70,000 beneficiaries, the largest of the 27 organizations.

RGV ACO Health Providers is comprised of six primary care group practices with 10 clinic locations serving the South Texas populations of Weslaco, Mercedes, Elsa, Donna, Mission, and surrounding communities. RGV is one of five Advance Payment ACO Models, which receive advance payments to help defray the costs of establishing the infrastructure needed to coordinate care for their beneficiaries. The Advance Payment Model was created to encourage rural and physician-based ACOs to participate. RGV is expected to serve over 6,000 beneficiaries.

These 27 organizations join the 32 Pioneer ACOs, announced in December 2011, which included two in Texas: North Texas ACO, serving Tarrant, Johnson, and Parker counties; and Seton Health Alliance, serving Central Texas. This program was designed for organizations already experienced in coordinating care across settings to allow them to move more rapidly from a shared savings payment model to a population-based payment model on a track consistent with but separate from the Medicare Shared Savings Program.

According to the CMS release, the agency is reviewing more than 150 applications from ACOs seeking to participate in the Shared Savings Program beginning July 1, and more than 50 of those are applying for the Advance Payment ACO Model.

For more information about the CMS ACO initiatives, go to www.cms.gov/aco.