(ACO) regulations - American Society of Anesthesiologists

CMS-1345-P 30
• Obtains a certification from our Chief Actuary that such expansion would
reduce (or would not result in any increase in) net program spending under applicable
titles; and
• Determines that such expansion would not deny or limit the coverage or
provision of benefits under Medicare, Medicaid, or CHIP.
Through the Innovation Center, we plan to explore alternative payment models
for the Shared Savings Program. As we test and refine these models, gain operational
experience, and put the necessary infrastructure in place to support program wide
implementation, including critical monitoring and patient protection infrastructure, we
plan to make these options available under the Shared Savings Program in future
rulemaking. Our intent is to move participants of the demonstration models that have a
demonstrated track record of realizing shared savings and high quality performance into
the Shared Savings Program in future agreement periods.
2. Independence at Home Medical Practices
Section 1866E of the Act, as added by section 3024 of the Affordable Care Act
authorizes the Secretary to conduct a demonstration program to test a payment incentive
and service delivery model that utilizes Independence at Home Medical Practices, which
are comprised of physician and nurse practitioner directed home-based primary care
teams, to provide services designed to reduce expenditures and improve health outcomes
for certain Medicare beneficiaries.
Subject to performance on quality measures established for the demonstration,
participating practices may be eligible to receive an incentive payment in the form of
shared savings. In determining whether savings were generated, the Secretary shall