Groups Urge CMS To Reference EHRs in New ACO Model Proposal

May 21, 2015 in News

On Monday, a coalition of 12 advocacy groups sent a letter to CMS requesting that the agency explicitly reference electronic health records in its “Next Generation Accountable Care Organization Model” request for applications, FierceHealthcare reports (Budryk, FierceHealthcare, 5/20).

Details of ACO Model

The new model uses a combination of fee-for-service and capitation. It creates four payment systems and two risk tracks for its participants, including one with almost full risk.

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.”

In addition, he wrote that the new model “encourages greater coordination and closer care relationships between ACO providers/suppliers and beneficiaries.” For example, the new model will make available several tools to bolster care management for beneficiaries, including telehealth.

CMS plans to allow Next Generation ACOs to receive payments for telehealth services, regardless of where the patient is located (iHealthBeat, 3/12).

Letter Details, Recommendations

In the letter, the groups criticized the financial incentives under the Next Generation ACO Model, emphasizing that it must focus on:

  • Engaging consumers; and
  • Offering comprehensive data.

The groups noted that electronic access to patient records would bolster that goal, as well as help improve patient experience and outcomes (FierceHealthcare, 5/20).

Specifically, the groups urged CMS to reinstate meaningful use as a quality metric under the Next General ACO Model. Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

The coalition wrote, “Requiring providers to report on the meaningful use quality measure will give patients more information about whether their doctors are meaningful users, and thus whether they, as patients, have electronic access to their own health information, the ability to securely email their providers, and are able to utilize other patient and family-facing functionalities of the meaningful use program” (Allen et al., “Morning eHealth,” Politico, 5/20).

Further, such electronic access could help patients better understand the importance of data sharing, according to the letter (Coalition letter, 5/18).

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