Health Care Law Blog

Braving the New Frontier of Accountable Care Organizations

On May 17, 2011, the Center for Medicare and Medicaid Innovation, a part of the Centers for Medicare & Medicaid Services ("CMS"), announced a "Pioneer ACO Model" designed for providers that are already experienced in coordinating care for patients across care settings.

The Pioneer ACO program provides higher risks and greater rewards in the first two years of the program than those available to non-Pioneer Accountable Care Organizations ("ACOs"). Specifically, non-Pioneer ACOs can choose from two tracks that vary on risk and reward under the CMS proposed ACO regulations.  Track One ACOs are those involved in a “one-sided model” that begins as a no-risk shared-savings payment system for the first two years and converts to a risk-sharing payment system in the third year. Track Two ACOs are those that are involved in a "two-sided model,” with risk-sharing (of both savings and losses) beginning in year one. Pioneer ACOs also participate in two-sided risk sharing from year one. Read More ›

Categories: Accountable Care Organizations, Health Care Reform, Hospitals

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Exchange Planning In Michigan Health Insurance

The 2010 health reform act, the Patient Protection and Affordable Care Act ("PPACA"), provides for the creation of health insurance "exchanges." Exchanges are programs designed to make it easier for eligible consumers and small businesses to compare and purchase health insurance coverage in a one-stop shopping format.  An Exchange is essentially a set of state regulated and standardized private health care plans, from which individuals may purchase health insurance that is eligible for federal subsidies. States choosing to create Exchanges are required to have them up and running by 2014. Read More ›

Categories: Health Care Reform, Health Insurance Exchange, Regulatory

Posted by: Gilbert M. Frimet

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CMS Stopping Acceptance of Early Retiree Reinsurance Applications

The Centers for Medicare and Medicaid Services ("CMS") announced that it will no longer accepting applications for its Early Retiree Reinsurance Program.  Based upon the applications that CMS has accepted and the rate at which the available $5 Billion is being disbursed, the government projects that it will use up the full allotted $5 Billion which has been set aside to fund this temporary program. 

Applications were first accepted on June 29, 2010 and the government is cutting off any further applications May 5, 2011.

Categories: Health Care Reform, Insurance

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