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Proposed Changes to Shared Savings Program Not Enough, Critics Say

Three years after launching the Medicare Shared Savings Program, Centers for Medicare and Medicaid Services (CMS) officials have proposed changes to the accountable care program, which will take effect in 2016. The changes are designed to attract small physician practices, encourage more participants to take on both upside and downside risk (i.e., both gain-sharing and cost-sharing), and simplify operations for participants and beneficiaries. In public comments last month, several groups including the American Hospital Association, American Medical Association, Association of American Medical Colleges, and the National Association of ACOs said the proposed changes don't do enough to encourage sustained interest in the program from providers because the potential financial opportunities are inadequate to support the investments needed to succeed as accountable care organizations.

Value-Based Payments to Reach 90 Percent of Medicare Spending by 2018

U.S. Department of Health and Human Services officials recently announced a three-year plan to accelerate movement away from Medicare fee-for-service payments and toward alternative payment models that promote "value" by achieving good health outcomes while controlling costs. The strategy will build on existing efforts, including Medicare's ACO and bundled payment programs, to develop more ambitious payment models, including paying for episodes of chronic illness and cancer care.

Program Aims to Prevent Delirium in ICUs

Reducing the use of sedation among ICU patients is one of the main goals of the ICU Liberation program, an effort to prevent the onset of delirium among critically ill patients. Launched by the Society of Critical Care Medicine, the program also encourages providers to better manage patients' pain, encourage movement, and follow other steps in a care bundle shown to reduce delirium, dependence on mechanical ventilators, and other complications of care. The program has produced results in 16 Northern California hospitals and has recently received funding from the Gordon and Betty Moore Foundation to expand it nationally.

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