Health law alphabet soup: ACOs, MLR and other implementation news

The Centers for Medicare and Medicaid Services has released the application for its shared savings program, and Health News Florida reports which of that state's providers will likely throw their hats into the ring. Meanwhile, CQ HealthBeat reports that the medical-loss ratio rule is undergoing its final Office of Management and Budget review. Also, the Obama administration is defending how the health law changes Medicare.

Modern Healthcare: CMS Releases Medicare Shared Savings Program Application
The CMS released its Medicare Shared Savings Program application for 2012 and will accept applications beginning Dec. 1. The 21-page application, available on the CMS' website, seeks information on the legal and governance structure of accountable care organizations, provider participation agreements, data sharing, and quality improvement and patient engagement efforts. The Medicare shared savings program, created by the Patient Protection and Affordable Care Act of 2010, offers hospitals and medical groups financial incentives to reduce costs and improve quality for a group of Medicare patients (Evans, 11/10).

Health News Florida: Suiting Up For ACO Game
Two major Orlando Hospitals and White-Wilson Medical Center in the Panhandle are among dozens of treatment providers in the state hoping to create alliances and reshape their business models to form "accountable care organizations." ... An ACO is an alliance between health groups that coordinates care for a group of patients within a single health (Davis, 11/10). 

CQ HealthBeat: Medical Loss Ratio Rule Undergoing Final Review Before Publication
The Office of Management and Budget is reviewing a final rule for medical loss ratios that should give some guidance as to how the so-called mini-med limited benefit plans will be allowed to operate. A review led by OMB officials is the last step before regulations are published in the Federal Register (Adams, 11/10).

CQ HealthBeat: Administration Defends The Way Health Care Law Changes Medicare
The Obama administration defended its progress on changes to the Medicare delivery system under last year's health care law in the face of skepticism from Republican lawmakers and weariness from Democrats who hope to see more detailed progress. Witnesses and lawmakers at a Senate Health, Education, Labor and Pensions Committee hearing agreed that the current fee-for-service system must be changed. But there was little consensus or detail on a best way to move forward (Ethridge, 11/10).

In other news related to the health law -;

Politico: Gallup: Uninsured Adults Rising
None of the components of President Obama's health care law that have taken effect appear to be affecting insurance coverage of adults over 26, according to a new poll Friday. The percentage of adults with no health insurance is the highest on record, with 17.3 percent of adults being uninsured in the third quarter of 2011, statistically tying the high set in the second quarter, Gallup found. Three years ago, in the third quarter of 2008, only 14.4 percent of adults lacked health insurance. Gallup cautions, however, that the record high coincides with a methodological change that samples cell-phone only respondents, which tend to be younger and thus more likely to be uninsured. Thus, some of the increase in the figure could be linked to this change (Mak, 11/11).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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