States, Feds look to expand ACOs and medical homes

News outlets report on efforts to expand accountable care organizations, medical homes and community health clinics.

Crain's New York Business, on ACOs in New York: "Authorized by the Patient Protection and Affordable Care Act signed into law by President Barack Obama in March, ACOs are intended to reward providers that shift their focus to preventive care and presumably reduce the need for expensive procedures. … Effective Jan. 1, 2012, Montefiore Medical Center in the Bronx, Westmed Medical Group in Westchester and other local institutions plan to become ACOs. Montefiore has already satisfied certain requirements, such as employing the majority of physicians who admit its patients and adopting the use of electronic medical records. … To maintain their ACO status, participating entities must show Medicare that they have met dozens of specific criteria for good care. ... An ACO receives a bonus if it saves Medicare money" (Scott, 6/13).

Chattanooga Times Free Press: "Health care leaders in Tennessee say they are open to participating in pilot projects seeking to repair the nation's fractured primary care system but say it's too early to talk specifics," while "Georgia officials are less forthcoming." The new health law includes "provisions to put primary care physicians back at the helm of patient care and to pay doctors to keep patients healthy, rather than for treating them when they are sick," such as medical homes. "The TennCare Bureau is considering a number of demonstration projects offered under health care reform" (Bregel, 6/14).

Modern Healthcare: "The full-scale launch of the CMS' new Center for Medicare and Medicaid Innovation is only six months away, and excitement among providers and experts is tempered with uncertainty about how the center will effectively manage so many quality and cost-control initiatives. ... Established by the Patient Protection and Affordable Care Act of 2010, the Center for Medicare and Medicaid Innovation is charged with developing innovative healthcare and delivery models that slow cost growth and improve quality. When the CMI begins its operations in January 2011, it will develop pilot projects—or join existing pilots in the private sector—to determine which approaches prove to be the most effective" (McKinney, 6/14).

American Medical News: "Community health centers have a tough time meeting all of their patients' needs, and health reform is expected to increase the burden on these facilities. A survey of federally qualified community health centers found that nearly all of them have difficulty getting specialty care for their uninsured patients. In addition, most have not adopted advanced electronic medical records, which can help with such care coordination. However, health centers affiliated with hospitals have fewer problems than unaffiliated centers when it comes to accessing imaging and off-site follow-up treatment for patients." The survey was conducted by the Commonwealth Fund (Trapp, 6/14).