Frequently Asked Questions (FAQs)
About CMS’s 2011 Accountable Care Organization Accelerated Development Learning Sessions
1. What is an ACO Accelerated Development Learning Session?
A: An Accelerated Development Learning Session (ADLS) is an opportunity for leadership from existing or emerging ACOs to develop a broad and deep understanding of how to establish and implement core functions to improve care delivery and population health while reducing growth in costs. Each ADLS will involve four steps: (1) pre-session planning, (2) an intensive in-person working meeting to jump start ACO formation by identifying shared goals, key challenges, and core competencies, (3) follow-on webinars, and (4) the completion of a comprehensive ACO implementation plan with year-by-year benchmarks over the next 3 years.
2. What is an Accountable Care Organization?
Section 3021 of the Affordable Care Act established the Center for Medicare and Medicaid Innovation (Innovation Center) for the purpose of examining new ways of delivering health care and paying health care providers that can save money for Medicare and Medicaid while improving the quality of care. Through Accelerated Development Learning Sessions, the Innovation Center will test whether intensive shared learning activities will expand and improve the capabilities of provider organizations to manage the care of a population of Medicare beneficiaries more effectively than organizations that do not participate in the ADLSs. Well coordinated care can improve beneficiaries’ quality outcomes and lower growth in their Medicare costs. CMS will evaluate the ADLSs by tracking changes in the care management competencies of participants during and after the sessions, and by comparing the performance of those ADLS participants that go on to participate in the Medicare Shared Savings Program to organizations in the Shared Savings Program that do not participate in the ADLSs.
Completion of the ADLS will not be a factor for selection or participation in a CMS ACO program. It is intended to provide new ACOs with the opportunity to learn from their peers about essential ACO functions and various ways to build capacity needed to achieve better care, better population health, and lower growth in costs.
Faculty at each ADLS will be senior leadership from organizations that have already developed many of the characteristics of an ACO and other experts in ACO core competencies - practitioners with first-hand experience with what is working and not working in the field. Each will offer a focused curriculum on core competencies for ACO development within four main areas: leadership and priority-setting; the clinical and operating challenge of transforming care delivery, including use of health information technology (IT); the managerial and financial challenge of assuming and managing risk; and meeting patient needs while reducing the total cost of care. Individual sessions and faculty will help participants complete corresponding sections of a comprehensive ACO implementation plan, including defining ACO goals and an action plan for establishing ACO core competencies.
A: An Accountable Care Organization (ACO) is a group of health care providers in a care delivery system who agree to accept joint responsibility for the medical care and management as well as the cost and quality outcomes of a designated population of patients. An ACO transforms the organization, delivery, and financing of care; it replaces fragmented, uncoordinated care with an arrangement in which providers work together to achieve shared goals of better care at a lower total cost. An ACO also preserves the ability of patients to choose and form an active partnership with the providers that best meet their own needs.
3. What types of health care organizations should register to attend the ADLS?
A: CMS encourages different types of existing and newly forming ACOs to register including but not limited to:
1. Physicians group practices
4. What topics will be covered at the ADLS?
2. Physicians and other professionals in Independent Practice Associations (IPAs)
3. Physician-Hospital Organizations
4. Integrated Delivery Systems
Interested organizations should be prepared to send a team of between two and four executives, including at least one with financial/management responsibilities and at least one with clinical responsibilities.
Due to space restrictions, ADLS in-person attendance will be limited to teams from provider organizations. Registration is not open to independent consultants, trade association representatives, or other interested parties. However, the plenary sessions of each ADLS will be broadcast live to the public via the Web. Please check this website in June for more details as to how to access the broadcast and other materials: http://innovations.cms.gov.
A: Teams that participate in the ADLS will learn from current ACOs and other experts in the field about the core competencies in establishing a successful ACO, such as:
5. What will attendance at an ADLS help organizations accomplish?
- Improving Care Delivery to Increase Quality and Reduce Cost Growth: Patient engagement and activation; primary care redesign; coordination across different settings of care and different provider organizations; identifying and managing patients at high risk for poor quality and high cost outcomes; quality measurement, feedback and reporting.
- Effective Use of Health Information Technology and Data Resources: Meaningful use of certified Electronic Health Records; updating, integrating, and maintaining clinical and financial data across clinical partners and from multiple sources; financial data systems that are sufficient for assessing and managing financial risk, and are integrated with clinical data systems.
- Ability to Assume and Manage Performance Based Financial Risk: Provider contracting and payment methods; assessing and managing financial risk; having capital resources to assume risk; distributing payment.
A: Participants will have a strong start on a comprehensive ACO implementation plan for establishing the core competencies of an ACO, based on an understanding of their current readiness to manage and coordinate care for a population of patients, and analysis of gaps in that readiness. They will have begun, with the assistance of program faculty, the crucial but difficult process of identifying specific goals that will guide the design and organization of a successful ACO to achieve the three part aims. Participants will also receive resources and toolkits to be able to complete, implement, and update a comprehensive ACO implementation plan that includes benchmarks for developing each core competency over the next one to three years.
6. Who should attend the ADLS from each ACO?
A: At least two senior leaders – one with financial/management responsibility and one with clinical responsibility – should attend the ADLS from each aspiring ACO. Two to four individuals from each organization may register for an ADLS. Individuals with the following roles or responsibilities in their health care organization would benefit most from the ADLS:
7. What will an organization’s team need to do in order to prepare to attend an ADLS?
- Chief Executive Officer, Chief Operating Officer, or someone with responsibility for the legal and financial management or strategic development of an aspiring ACO.
- Chief Medical Officer, or someone with clinical responsibility for care delivered in the health care organization(s) participating in an ACO.
- Chief Information Officer, or someone with clinical responsibility and oversight of health IT or information systems in an ACO.
- Individual from one or more health care organizations in an ACO with responsibility for developing ACO strategic plans or partnerships.
A: Registrants must complete the registration form in order to participate in an ADLS. Potential participants are also strongly encouraged to complete a comprehensive planning tool, which will allow them to take full advantage of the hands-on learning activities during the ADLS. The registration form and comprehensive planning tool are available on the ACO ADLS website at https://acoregister.rti.org. This planning tool is intended to help participants understand baseline capacity and help focus on areas of functional capacity that they might choose to develop further. Additionally, attendees accepted to the ADLS should (a) look at cost and quality data in their service area from CMS (Medicare fee-for-service utilization and cost data by region are available at http://healthindicators.gov/), other payers, and other sources; and (b) and identify the providers with whom they will partner in forming their ACOs.
8. How does an organization’s team complete registration for the ADLS?
A: The registration form and comprehensive planning tool are available on the ACO ADLS website, https://acoregister.rti.org. Organizations may need to gather information from multiple sources to complete the planning tool.
9. What will participants need to do after the ADLS?
A: Using the ACO implementation plan begun at the ADLS, each participating team can identify remaining gaps in readiness and attend web-based seminars and follow-on learning modules available through the ACO Accelerated Development Learning Program They can also complete their own comprehensive ACO implementation plan and use ADLS implementation tools to execute their plans.
10. Will follow-up web-based seminars and learning modules be available to ACO ADLS participants?
A: ACO ADLS participants can access these resources via the ACO ADLS Web site, https://acoregister.rti.org. Please see the Webinars page for more information.
11. What does it cost to attend the ADLS and access other follow-up resources?
A: There is no registration fee for attending the ADLS, but attendees are responsible for their own travel, parking, meals and overnight-stay expenses. Follow-up web-based seminars and written resources will also be free.
12. Why are there ADLSs scheduled?
A: The ADLS will be repeated in three regions of the country to help to minimize the burden of travel for attendees. Registration will be on a first-come, first-served basis and space is limited at each ADLS.
13. Can an organization attend more than one ADLS, or send a team of more than four people?
A: No, space at each ADLS is limited. Organizations are not restricted to attend the ADLS scheduled in their region, but each organization may only send one team of between two to four people to one ADLS.
14. What are the locations, dates, and times for the four in-person meetings associated with the ADLSs?
A: The first ADLS was held in Minneapolis, MN, starting 1:00 p.m., June 20, 2011 and ending 12:00 p.m., June 22, 2011.
15. How will organizational teams be selected to attend each ADLS?
The second ADLS was held in San Francisco CA, starting at 8 a.m., September 15th, 2011, and ending 6:00 p.m., September 16th, 2011.
A: Teams will be accepted on a first-come, first-served basis. To complete registration, each health care organization needs to identify a minimum of a two executives and complete the full registration form, including the planning tool. Organizations must submit the names, titles and description of responsibility for all individuals who will attend the ADLS.
16. Once an organization has been accepted, can it send substitutes or additional team members?
A: An organization that has completed registration to attend the ADLS may not send additional team members. CMS understands that under certain extenuating circumstances, some senior leadership team members who originally registered will not be able to attend the ADLS. In those rare cases, CMS will accept a substitute team member, if the substitute is another executive or leader with senior level responsibilities for ACO operations.
17. When does registration for each ADLS close?
A: Registration will close when each of the ADLSs reaches its capacity for the in-person meeting.
18. Are there any resources available for health care organizations that cannot attend an ADLS?
A: Yes. Please see the Agenda page for archived webcast sessions and other materials.
19. Who do I contact for more information about the ADLSs?
A: Please visit the registration Web site https://acoregister.rti.org and click on “contact us” to send any questions or comments.