Three companies have started a reinsurance program for the new Medicare accountable care organizations (ACOs).
The new reinsurance program will help organizations that participate in the Medicare ACO Shared Savings Program limit the risk of big losses, the companies say.
The companies are Star Line Group, East Falmouth, Mass., an underwriting manager; U.S. Advisors Inc., Brentwood, Tenn., a reinsurance broker; and Ascendant Care, Washington, a consulting firm.
An ACO is supposed to be an organization that gives doctors, hospitals and other ACO providers financial incentives to make the care for a medical condition as efficient as possible, to get away from the system of having an insurer or other payer encourage provider to drive up costs by billing separately for each service provided.
The Patient Protection and Affordable Care Act of 2010 (PPACA) requires the Centers for Medicare & Medicaid Services (CMS) to try using ACOs and other new reimbursement strategies to reduce Medicare program costs.
CMS has developed the Medicare Shared Savings Program and another ACO program, the Pioneer ACO program.
The reinsurance program organizers recognize that one unique feature of the ACO program is that cash flow may be delayed, Star Line and the other companies say.
Ascendant Care would be responsible for reviewing ACO reinsurance candidates and monitoring their performance.
Mike Barrett, chief executive of Ascendant Care, says access to reinsurance should help expand the number of organizations that can participate in the Medicare Shared Savings Program.
CMS: PARENTS SAY THEY LIKE CHIP
Parents with children in Medicaid and Children’s Health Insurance Program (CHIP) plans may be about as happy with access to doctors and dentists as parents with children in enrolled in employer-sponsored plans are.
Michael Perry, a partner at Lake Research Partners Inc., Washington, has reported that finding in a report prepared for CMS.
Lake Research is a subcontractor for a firm that CMS commissioned to find how parents like Medicaid and CHIP coverage.
Pollsters conducted interviews of 1,936 parents under age 19 in households with incomes below 250% of the federal poverty level.