POLICY BEAT Weekly Digest October 17th – October 21st, 2011 This Week in Health Policy… • ACO Final Rules • Cuts ‐ Wisconsin • EHR Medicaid Incentives • ACA Implementation –Local Level

Office of Health Policy and Government Relations Care Coordination: CMS Announces ACO Final Rules

This week, the Centers for and Medicaid Services (CMS) announced the final rules for setting up Accountable Care Organizations

(ACOs). The rules define two incentive programs ‐ the Medicare Shared

Savings Program, and the Advanced Payment Model ‐ both of which are intended to facilitate robust physician participation in ACOs. More details available here. CMS will conduct a learning session about ACOs from

November 17‐18 in Baltimore. You may sign up here.

Advanced Payment Model Highlights:

•Upfront fixed payment •Upfront payment based on the number of Medicare patients served •Monthly payments based on the number of Medicare patients

•Designed for physician‐owned and rural ACOs

Protecting Medicaid: Wisconsin Proposes $500M Cuts

This week, Wisconsin health officials heard the displeasure of health care advocates over Governor Scott Walker’s proposal to reduce the state’s Medicaid expenses by $500 million by 2013. BadgerCare , as the program is known, proposes to shift more than 200,000 families from the plan to “benchmark” plans that offer fewer benefits. This move would require a federal waiver. BadgerCare serves over a million people, a population that amounts to about one in five Wisconsin residents.

More details are available here.

Image credit: Wisconsin Network EHR Incentives: How Medicaid Programs Are Preparing

States are building the infrastructure necessary to help their Medicaid providers adopt health IT systems, in order to meet meaningful use requirements, and qualify for CMS EHR incentives. Alabama’s Provider Electronic Solutions, for example, is available to all Alabama Medicaid providers at no cost. Details of the program are available here.

Photo credit: Alabama Medicaid Agency Health System Reform: ACA Implementation @ the County Level

The Healthy Howard Health Plan was developed by Howard County, Maryland, to serve as the first line of defense for health promotion and disease prevention among the county’s uninsured. The makes such a plan increasingly more viable at the local level. More details are available here.

Key Points:

Policy Beat archive: Click here •Total county population 287K, 20K uninsured

Image credit: Healthy Howard Health Plan •‘Primary care homeʹ model •Up to six doctor visits per year, standard •Consult care coordinator at each doctor visit •Funded by the county and community partnerships

What You Can Do

•Please call your Members of Congress, and urge them to preserve funding for training minority doctors. Contact info here.

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For the latest health policy updates, visit our RSS News Feed. Resources

• “New Affordable Care Act Tools Offer Incentives for Providers to Work Together When Caring for People With Medicare.” HealthCare.Gov. October 20, 2011. Web. http://www.healthcare.gov/news/ factsheets/2011/10/accountable‐care10202011a.html

• Bauer, Scott. “Public Speaks Out Against Wisconsin Medicaid Cuts.” Associated Press. October 19, 2011. Web. http://www.twincities.com/health/ci_19148862?source=rss

• “EHR Incentive Programs –Medicaid State Information.” Centers for Medicare and Medicaid Services. October 2, 2011. Web. http://www.cms.gov/EHRIncentivePr ograms/40_MedicaidStateInfo.asp

• “Provider Electronic Solutions Software.” Alabama Medicaid Agency. October 2011. Web. http://medicaid.alabama.go v/CONTENT/6.0_Providers/6. 10_Provider_Electronic_Sol utions.aspx

• “About Us –Healthy Howard Health Plan.” Healthy Howard Health Plan. October 2011. Web. http://www.healthyhowardplan.org/about