CMS to unwind reporting rules for ACOs influenced by hurricanes, fires

The CMS has issued an interim final rule to provide accountable-care organizations more leniency on quality reporting standards when they were influenced by disasters this season.

The interim final rule provides set affected ACOs’ minimum quality score towards the average quality score for those ACOs within the Medicare Shared Savings Program.

Furthermore, the CMS will reduce potential shared losses for affected ACOs in downside risk contracts — individuals in Tracks two or three — through the number of the ACO’s population impacted by a tragedy.

ACOs which had 20% or even more of the assigned beneficiaries residing in a county that declared a condition of emergency throughout the 2017 performance year is going to be qualified for that relaxed reporting standards, the company stated.

The rule is as a result of feedback from ACOs in Puerto Rico, Florida, Texas and California that hurricanes and wildfires within their region have greatly impacted remarkable ability to provide choose to their beneficiaries, resulting in inefficiencies and much more spending.

The CMS made similar reporting changes for physicians impacted by disasters who take part in MACRA.

ACOs have reported towards the CMS that patients situated in impacted areas have limited use of primary care or pharmacies, so that they are utilizing pricey emergency rooms to get healthcare services. Ale ACOs to reduce readmissions and unplanned admissions impacts their performance within the Shared Savings Program.

Other ACOs have stated they’ve postponed relieve inpatients since the necessary publish-discharge services are unavailable. ACOs also have reported they cannot perform preventive services like cancer screening or diabetic eye exams. ACOs are scored within the program depending on how frequently they offer such services.

Medical records to report for that program might even be “inaccessible” for many providers due to disasters, the CMS stated.

The rules are going to get into effect Jan. 20, 2018.

Maria Castellucci is really a general assignment reporter covering place news for contemporary Healthcare’s website and print edition. She covers finances, acquisitions along with other healthcare topics in markets across the nation. Castellucci graduated from Columbia College Chicago and began working at Modern Healthcare in September 2015.

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