Medicare Program; Start-Up Funding in Support of the Vermont All-Payer Accountable Care Organization (ACO) Model-Cooperative Agreement, 91174-91175 [2016-30269]
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Federal Register / Vol. 81, No. 242 / Friday, December 16, 2016 / Notices
assets or the ownership of, control of, or
the power to vote shares of a bank or
bank holding company and all of the
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owned by the bank holding company,
including the companies listed below.
The applications listed below, as well
as other related filings required by the
Board, are available for immediate
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indicated. The applications will also be
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writing on the standards enumerated in
the BHC Act (12 U.S.C. 1842(c)). If the
proposal also involves the acquisition of
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(12 U.S.C. 1843). Unless otherwise
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Unless otherwise noted, comments
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2017.
A. Federal Reserve Bank of St. Louis
(David L. Hubbard, Senior Manager)
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Comments.applications@stls.frb.org:
1. Farmers Bancorp, Inc., Blytheville,
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Board of Governors of the Federal Reserve
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[FR Doc. 2016–30301 Filed 12–15–16; 8:45 am]
BILLING CODE 6210–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–5521–N]
mstockstill on DSK3G9T082PROD with NOTICES
Medicare Program; Start-Up Funding in
Support of the Vermont All-Payer
Accountable Care Organization (ACO)
Model—Cooperative Agreement
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice.
AGENCY:
The purpose of this notice is
to announce issuance of the November
23, 2016 single-source cooperative
agreement funding opportunity
SUMMARY:
VerDate Sep<11>2014
18:42 Dec 15, 2016
Jkt 241001
available solely to Vermont’s Agency of
Human Services in order to provide care
coordination and bolster collaboration
for practices and community-based
health care providers as part of the
Vermont All-Payer Accountable Care
Organization (ACO) Model.
DATES: The performance period of the
Vermont All-Payer ACO Model will
begin on January 1, 2017, and conclude
on December 31, 2022.
FOR FURTHER INFORMATION CONTACT:
Stephen Cha, (410) 786–1876.
SUPPLEMENTARY INFORMATION:
I. Background
The Vermont All-Payer Accountable
Care Organization Model (Model) is the
Centers for Medicare & Medicaid
Services’ (CMS) new test within the
Center for Medicare and Medicaid
Innovation of an alternative payment
model in which the major health care
payers—Medicare, Medicaid, and
commercial health care payers—
incentivize health care value and
quality under the same payment
structure for health care providers
throughout the state’s care delivery
system to transform health care for the
entire state and its population. An
Accountable Care Organization (ACO) is
an entity formed by certain health care
providers that accepts financial
accountability for the overall quality
and cost of medical care furnished to,
and health of, beneficiaries attributed to
the entity.
CMS believes that states can be
critical partners of the federal
government and other health care
payers to facilitate the design,
implementation, and evaluation of
community-centered health systems that
can deliver significantly improved cost,
quality, and population health
performance results for all state
residents, including Medicare,
Medicaid, and Children’s Health
Insurance Program (CHIP) beneficiaries.
States have policy and regulatory
authorities, as well as ongoing
relationships with commercial
healthcare payers, health plans, and
health care providers that can accelerate
delivery system reform. CMS has
previously partnered with states to
accelerate delivery system reform
through initiatives such as the State
Innovations Model (SIM). SIM provides
state-based healthcare transformation
efforts with funding to test the ability of
states to utilize policy and regulatory
levers to accelerate multi-payer health
care transformation.
Vermont, a SIM state awardee,
approached CMS with a desire to
include Medicare in the state’s
PO 00000
Frm 00060
Fmt 4703
Sfmt 4703
multipayer payment and care delivery
model, and Vermont publicly released
its proposal on January 25, 2016. CMS
reviewed Vermont’s proposal and
determined that it met the necessary
requirements to explore a potential
Vermont-specific model in which
Medicare aligns with Vermont’s
healthcare transformation efforts. In
October 2016, CMS and the State of
Vermont entered into the Vermont AllPayer Accountable Care Organization
Model Agreement (‘‘State Agreement’’)
to implement the Vermont All-Payer
ACO Model. The Vermont All-Payer
ACO Model will be a 6-year model
beginning in 2017 and ending in 2022.
As part of the Model, Vermont health
care providers will participate in a
Vermont-specific Medicare ACO
initiative (the Vermont Medicare ACO
Initiative), which is largely based on
CMS’ Next Generation ACO Model.
CMS will provide one-time start-up
funding in the amount of $9,500,000 to
the State to assist Vermont health care
providers with care coordination and
bolster their collaboration with
community-based resources. CMS will
provide the start-up funding as a
cooperative agreement funding
opportunity available solely to
Vermont’s Agency of Human Services,
as announced in this notice. More
information about the Vermont AllPayer ACO Model can be found at
https://innovation.cms.gov/initiatives/
vermont-all-payer-aco-model/.
Through the Model, CMS will test
whether the quality of health care for
Vermont residents improves and
healthcare expenditures for
beneficiaries across payers (including
Medicare fee-for-service, Vermont
Medicaid, Vermont commercial plans,
and Vermont self-insured plans)
decrease if—
• The aforementioned payers offer
Vermont ACOs risk-based arrangements
tied to health outcomes and healthcare
expenditures;
• The majority of Vermont health care
providers enter into such risk-based
arrangements; and
• The majority of Vermont residents
across payers are aligned to an ACO
bound by these arrangements.
CMS and Vermont aim for broad ACO
participation throughout the state,
across all the significant payers and the
majority of the care delivery system, to
make redesigning the entire care
delivery system a rational business
strategy for Vermont health care
providers and payers. As set forth in the
State Agreement, Vermont commits to
achieving statewide health outcomes,
financial targets, and ACO scale
(percentage of Vermont residents
E:\FR\FM\16DEN1.SGM
16DEN1
Federal Register / Vol. 81, No. 242 / Friday, December 16, 2016 / Notices
mstockstill on DSK3G9T082PROD with NOTICES
aligned to an ACO) targets—both for
Medicare and across all significant
healthcare payers. Additionally, CMS
and Vermont aim for this Model to
deliver meaningful improvements in the
health of a state’s entire population by
transforming the relationships between
and amongst care delivery and public
health systems across Vermont.
II. Provisions of the Notice
The purpose of this notice is to
announce a single source cooperative
agreement funding opportunity in the
amount of $9,500,000 available solely to
Vermont’s Agency of Human Services
(AHS) to support care coordination and
bolster collaboration for practices and
community-based health care providers
as part of the Vermont All-Payer ACO
Model. A single-source award to the
AHS will enable CMS to provide
assistance to Vermont for the following
purposes: To connect Medicare fee-forservice beneficiaries with communitybased resources, coordinate transitions
across care settings with appropriate
involvement of the Medicare fee-forservice beneficiaries’ primary care
providers, coordinate care across health
care providers, support health
promotion and self-management by
Medicare fee-for-service beneficiaries,
and support practice improvement and
transformation. These activities are
necessary for Vermont to achieve the
health outcomes and financial goals
required under the Vermont All-Payer
ACO Model.
CMS and Vermont believe the
Vermont All-Payer ACO Model can
support health care providers, including
physicians in small practices, to
succeed as health care moves from feefor-service to value-based payment
systems. Participation by health care
providers and payers in the model will
be voluntary, and CMS and Vermont
expect to work closely together to
achieve sufficient uptake. In particular,
this Model is being implemented using
the Secretary’s authority in section
1115A of the Social Security Act (the
Act) and Vermont’s Global Commitment
to Health demonstration project
authorized under section 1115 of the
Act. Together these authorities make it
possible for physicians and other
clinicians in Vermont to participate the
aligned and state-specific Vermont
Medicare ACO Initiative and Medicaid
ACO initiative. Under the Quality
Payment Program, the two-sided risk
portion of the Vermont Medicare ACO
Initiative meets the criteria to be an
Advanced Alternative Payment Model.
Health care providers participating in
the two-sided risk portion of the
Vermont Medicare ACO Initiative may
VerDate Sep<11>2014
18:42 Dec 15, 2016
Jkt 241001
potentially qualify for the APM
Incentive Payments starting in
performance year 2018.
This single-source funding
opportunity to the AHS is designed to
meet the goals of the cooperative
agreement based on the AHS’ existing
knowledge and role in supporting the
Model, its existing partnerships and
collaborations with Vermont health care
providers, and its resources and ability
to deploy the funding immediately.
III. Collection of Information
Requirements
This document does not impose
information collection requirements,
that is, reporting, recordkeeping or
third-party disclosure requirements.
Consequently, there is no need for
review by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 3501 et seq.).
Dated: December 6, 2016.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. 2016–30269 Filed 12–15–16; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers: CMS–4040, CMS–
10156, CMS–10170, CMS–10198, CMS–
10227, CMS–10344, CMS–10501, CMS–R–
266, and CMS–10282]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, HHS.
ACTION: Notice.
AGENCY:
The Centers for Medicare &
Medicaid Services (CMS) is announcing
an opportunity for the public to
comment on CMS’ intention to collect
information from the public. Under the
Paperwork Reduction Act of 1995 (the
PRA), federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information (including each proposed
extension or reinstatement of an existing
collection of information) and to allow
60 days for public comment on the
proposed action. Interested persons are
invited to send comments regarding our
burden estimates or any other aspect of
this collection of information, including
any of the following subjects: the
necessity and utility of the proposed
SUMMARY:
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Sfmt 4703
91175
information collection for the proper
performance of the agency’s functions;
the accuracy of the estimated burden;
ways to enhance the quality, utility, and
clarity of the information to be
collected; and the use of automated
collection techniques or other forms of
information technology to minimize the
information collection burden.
DATES: Comments must be received by
February 14, 2017.
ADDRESSES: When commenting, please
reference the document identifier or
OMB control number. To be assured
consideration, comments and
recommendations must be submitted in
any one of the following ways:
1. Electronically. You may send your
comments electronically to https://
www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) that are accepting
comments.
2. By regular mail. You may mail
written comments to the following
address: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: Document Identifier/OMB
Control Number ll Room C4–26–05,
7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, you may make your request
using one of following:
1. Access CMS’ Web site address at
https://www.cms.hhs.gov/
PaperworkReductionActof1995.
2. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
Reports Clearance Office at (410) 786–
1326.
SUPPLEMENTARY INFORMATION:
Contents
This notice sets out a summary of the
use and burden associated with the
following information collections. More
detailed information can be found in
each collection’s supporting statement
and associated materials (see
ADDRESSES).
CMS–4040 Request for Enrollment in
Supplementary Medical Insurance
CMS–10156 Retiree Drug Subsidy
(RDS) Application and Instructions
CMS–10170 Retiree Drug Subsidy
(RDS) Payment Request and
Instructions
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[Federal Register Volume 81, Number 242 (Friday, December 16, 2016)]
[Notices]
[Pages 91174-91175]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-30269]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5521-N]
Medicare Program; Start-Up Funding in Support of the Vermont All-
Payer Accountable Care Organization (ACO) Model--Cooperative Agreement
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The purpose of this notice is to announce issuance of the
November 23, 2016 single-source cooperative agreement funding
opportunity available solely to Vermont's Agency of Human Services in
order to provide care coordination and bolster collaboration for
practices and community-based health care providers as part of the
Vermont All[dash]Payer Accountable Care Organization (ACO) Model.
DATES: The performance period of the Vermont All-Payer ACO Model will
begin on January 1, 2017, and conclude on December 31, 2022.
FOR FURTHER INFORMATION CONTACT: Stephen Cha, (410) 786-1876.
SUPPLEMENTARY INFORMATION:
I. Background
The Vermont All-Payer Accountable Care Organization Model (Model)
is the Centers for Medicare & Medicaid Services' (CMS) new test within
the Center for Medicare and Medicaid Innovation of an alternative
payment model in which the major health care payers--Medicare,
Medicaid, and commercial health care payers--incentivize health care
value and quality under the same payment structure for health care
providers throughout the state's care delivery system to transform
health care for the entire state and its population. An Accountable
Care Organization (ACO) is an entity formed by certain health care
providers that accepts financial accountability for the overall quality
and cost of medical care furnished to, and health of, beneficiaries
attributed to the entity.
CMS believes that states can be critical partners of the federal
government and other health care payers to facilitate the design,
implementation, and evaluation of community-centered health systems
that can deliver significantly improved cost, quality, and population
health performance results for all state residents, including Medicare,
Medicaid, and Children's Health Insurance Program (CHIP) beneficiaries.
States have policy and regulatory authorities, as well as ongoing
relationships with commercial healthcare payers, health plans, and
health care providers that can accelerate delivery system reform. CMS
has previously partnered with states to accelerate delivery system
reform through initiatives such as the State Innovations Model (SIM).
SIM provides state-based healthcare transformation efforts with funding
to test the ability of states to utilize policy and regulatory levers
to accelerate multi-payer health care transformation.
Vermont, a SIM state awardee, approached CMS with a desire to
include Medicare in the state's multipayer payment and care delivery
model, and Vermont publicly released its proposal on January 25, 2016.
CMS reviewed Vermont's proposal and determined that it met the
necessary requirements to explore a potential Vermont-specific model in
which Medicare aligns with Vermont's healthcare transformation efforts.
In October 2016, CMS and the State of Vermont entered into the Vermont
All-Payer Accountable Care Organization Model Agreement (``State
Agreement'') to implement the Vermont All-Payer ACO Model. The Vermont
All-Payer ACO Model will be a 6-year model beginning in 2017 and ending
in 2022.
As part of the Model, Vermont health care providers will
participate in a Vermont-specific Medicare ACO initiative (the Vermont
Medicare ACO Initiative), which is largely based on CMS' Next
Generation ACO Model. CMS will provide one-time start-up funding in the
amount of $9,500,000 to the State to assist Vermont health care
providers with care coordination and bolster their collaboration with
community-based resources. CMS will provide the start-up funding as a
cooperative agreement funding opportunity available solely to Vermont's
Agency of Human Services, as announced in this notice. More information
about the Vermont All-Payer ACO Model can be found at https://innovation.cms.gov/initiatives/vermont-all-payer-aco-model/.
Through the Model, CMS will test whether the quality of health care
for Vermont residents improves and healthcare expenditures for
beneficiaries across payers (including Medicare fee-for-service,
Vermont Medicaid, Vermont commercial plans, and Vermont self-insured
plans) decrease if--
The aforementioned payers offer Vermont ACOs risk-based
arrangements tied to health outcomes and healthcare expenditures;
The majority of Vermont health care providers enter into
such risk-based arrangements; and
The majority of Vermont residents across payers are
aligned to an ACO bound by these arrangements.
CMS and Vermont aim for broad ACO participation throughout the
state, across all the significant payers and the majority of the care
delivery system, to make redesigning the entire care delivery system a
rational business strategy for Vermont health care providers and
payers. As set forth in the State Agreement, Vermont commits to
achieving statewide health outcomes, financial targets, and ACO scale
(percentage of Vermont residents
[[Page 91175]]
aligned to an ACO) targets--both for Medicare and across all
significant healthcare payers. Additionally, CMS and Vermont aim for
this Model to deliver meaningful improvements in the health of a
state's entire population by transforming the relationships between and
amongst care delivery and public health systems across Vermont.
II. Provisions of the Notice
The purpose of this notice is to announce a single source
cooperative agreement funding opportunity in the amount of $9,500,000
available solely to Vermont's Agency of Human Services (AHS) to support
care coordination and bolster collaboration for practices and
community-based health care providers as part of the Vermont
All[dash]Payer ACO Model. A single-source award to the AHS will enable
CMS to provide assistance to Vermont for the following purposes: To
connect Medicare fee-for-service beneficiaries with community-based
resources, coordinate transitions across care settings with appropriate
involvement of the Medicare fee-for-service beneficiaries' primary care
providers, coordinate care across health care providers, support health
promotion and self-management by Medicare fee-for-service
beneficiaries, and support practice improvement and transformation.
These activities are necessary for Vermont to achieve the health
outcomes and financial goals required under the Vermont All-Payer ACO
Model.
CMS and Vermont believe the Vermont All-Payer ACO Model can support
health care providers, including physicians in small practices, to
succeed as health care moves from fee-for-service to value-based
payment systems. Participation by health care providers and payers in
the model will be voluntary, and CMS and Vermont expect to work closely
together to achieve sufficient uptake. In particular, this Model is
being implemented using the Secretary's authority in section 1115A of
the Social Security Act (the Act) and Vermont's Global Commitment to
Health demonstration project authorized under section 1115 of the Act.
Together these authorities make it possible for physicians and other
clinicians in Vermont to participate the aligned and state-specific
Vermont Medicare ACO Initiative and Medicaid ACO initiative. Under the
Quality Payment Program, the two-sided risk portion of the Vermont
Medicare ACO Initiative meets the criteria to be an Advanced
Alternative Payment Model. Health care providers participating in the
two-sided risk portion of the Vermont Medicare ACO Initiative may
potentially qualify for the APM Incentive Payments starting in
performance year 2018.
This single-source funding opportunity to the AHS is designed to
meet the goals of the cooperative agreement based on the AHS' existing
knowledge and role in supporting the Model, its existing partnerships
and collaborations with Vermont health care providers, and its
resources and ability to deploy the funding immediately.
III. Collection of Information Requirements
This document does not impose information collection requirements,
that is, reporting, recordkeeping or third-party disclosure
requirements. Consequently, there is no need for review by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995 (44 U.S.C. 3501 et seq.).
Dated: December 6, 2016.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2016-30269 Filed 12-15-16; 8:45 am]
BILLING CODE 4120-01-P