Providers warn that ACOs that are not ready to assume the downside risk will drop out of the program if CMS does not extend the agreement period.
Provider associations are calling for an extension of the Medicare Shared Savings Program Track 1 because some accountable care organizations are not ready for downside risk.
The providers said in a joint letter to Seema Verma, administrator for the Centers for Medicare & Medicaid Services:
Many ACOs remain in Track 1 because they are unprepared to assume risk requiring them to potentially pay millions of dollars to Medicare, which is simply not practical or feasible for most of these organizations.
Read the letter signed by The National Association of ACOs, the American College of Physicians, the American Medical Association, the Association of American Medical Colleges, the Medical Group Management Association, and Premier healthcare alliance.
Quoting from the letter:
Our recommendations reflect our unified expectation and desire to see the MSSP achieve the long-term sustainability necessary to enhance care coordination for Medicare beneficiaries, lower the growth rate of healthcare spending and improve quality in the Medicare program. Specifically, our key goals for the MSSP include encouraging increased participation, enabling ACOs to continue in the program and creating a successful, long-term ACO model for Medicare. It is in Medicare’s interest for ACOs to continue in order to provide high quality care for beneficiaries and to reduce the growth rate of Medicare spending.
Read more about concerns about too rapid application of risk in Healthcare Informatics
Not all agree. Policy insiders worry the request, if granted, would mean the ACO program would continue to produce only meager savings, doing little to advance the move into value-based care. Last year, HHS’ Office of Inspector General said MSSP ACOs reduced Medicare spending by about $1 billion in three years. Every year, Medicare spends more than $500 billion.
Jeff Goldsmith, an adviser at Navigate Consulting:
It’s clearly not going to save the federal government any money until many more people have downside risk,” said . “It undercuts the rationale program to continue to extend [no risk] indefinitely.
Sean Cavanaugh, a former director of the Center for Medicare during the Obama administration paused at the idea of extending the time line.
The goal of value-based care is to hold providers accountable for the cost and quality of patients’ care. To make sure that providers are in it for the right reason, there needs to be deadlines.
Read more pushback in Modern Healthcare
Inspite of requests to delay, the Centers for Medicare and Medicaid Services is moving ahead with a new voluntary bundled payment model.
CMS contends that it has provided a plethora of information on its website about applying for and participating in the new voluntary bundled payment model, as well as hosted a couple of question-and-answer webinar sessions to further detail its plans.
Read more about the controversy at HealthData Management