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Well Star Health Network has been selected to participate in the Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organization (ACO), a multifaceted new program sponsored by the Centers for Medicare and Medicaid Services (CMS).
CMS is proposing to allow ACOs considerable flexibility in providing documentation to meet these requirements with the expectation that over time, once these different processes are evaluated based upon actual experience, CMS will provide more specific requirements in order to promote successful outcomes.ACOs able to meet the quality standards will be eligible to receive payments for shared savings, and under the second model described below, may also be required to share in any losses.The Shared Savings Program is designed to promote collaboration, coordination and accountability of providers, to encourage providers to make investments in infrastructure, to redesign healthcare processes, and to develop a more integrated delivery system with better outcomes regarding quality and efficiency.Your care providers will be paid partly based on providing improved care, improved coordination, and improved value—not just more tests and procedures.If beneficiaries choose not to share their medical information, they may contact CMS at 1-800-MEDICARE.CMS will issue a warning and possibly terminate a participation agreement if an ACO fails to meet the criteria of 5,000 beneficiaries.
ACO applicants must provide a list of national provider identifiers (NPIs) associated with the ACO providers and suppliers. ACO participants will have to demonstrate sufficient mechanisms to promote higher quality of care, enhance coordination of care and other processes necessary to meet the needs and concerns of patients and their families, including effectively engaging patients and their families in medical decision-making.
Part of the Affordable Care Act ( the Act’), these new Federal regulations proposed March 31, 2011, implement the Medicare Shared Savings Program (the Program) established under section 1899 of the Social Security Act.
The three main goals of the Program are: (1) better care for individuals; (2) better health outcomes; and (3) lower growth in health care expenditures.
The doctors and other providers who are helping care for you will communicate with each other, and partner with you in making health care decisions.
Your doctors use data from Medicare to help improve how they provide care.
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