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CMS Officials Outline Near-Term Plans on ACOs, Payment Innovation, 'Dual-Eligibles'

By John Reichard, CQ HealthBeat Editor

November 29, 2010 -- Centers for Medicare and Medicaid Services (CMS) officials outlined their near-term plans for provisions of the health law dealing with accountable care organizations (ACOs), new forms of payment and health care delivery innovation, and "dual eligibles" — the 9 million Americans eligible both for Medicare and Medicaid.

The officials spoke in an "open-door forum," a series in which industry officials and members of the general public exchange views via teleconference on various issues relating to Medicare and Medicaid.

Deputy CMS Administrator Jon Blum said that his agency wants to encourage solo practitioners and small group practices to take part in accountable care organizations, in which teams of doctors and other providers join together to contract with Medicare to provide more efficient, higher-quality care. A recent "request for information" by CMS aims to get input on how best to encourage such participation before the agency issues a proposed rulemaking on ACOs in late December or in early 2011, Blum said.

Richard Gilfillan, acting director of the Center for Medicare and Medicaid Innovation, told the teleconference that his office is developing an operating plan for testing new payment systems and new forms of health care delivery to improve health, create higher-quality care and lower costs. He encouraged health care industry officials to offer advice on what should go into the plan and said a website would be developed to spur the communication of ideas.

Melanie Bella, head of the Federal Coordinated Health Care Office, addressed issues relating to the improvement of care for those eligible for Medicare and Medicaid, a particularly frail population with multiple chronic illnesses. She said her office is developing a list of the ways in which the two programs conflict with each other and create barriers to care. She said the list will be released to the public in the near future and will enumerate possible legislative or regulatory fixes and assign them priorities. She said the public will be able to share ideas about the list.

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