ACOs aren't ready to take on risk, lawmakers say

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A bipartisan group of lawmakers urged CMS Administrator Seema Verma to allow ACOs to do a third three-year stint in Track 1 of the Medicare Shared Savings Program.

Currently, ACOs in Track 1 are capped at two three-year contracts before they are required under the program to graduate to another track and begin taking on two-sided risk. Most ACOs (82 percent) in the MSSP program are currently in Track 1, and the first cohort is in its final year at this level of risk.

"Most of these ACOs are simply not ready to take on risk, and compelling them to do so is not realistic given that MSSP performance data is only available for years 2013-2016 and the capital required to participate in a two-sided risk model can reach into the millions," the members of Congress wrote in an April 13 letter to Ms. Verma.

Moving ACOs to two-sided risk before they are ready could cause many to revert to fee-for-service payment models and lose investments they've already made in value-based care infrastructure, they cautioned.

The letter was signed by Reps. Suzan DelBene, D-Wash.; Erik Paulsen, R-Minn.; Earl Blumenauer, D-Ore.; Terri Sewell, D-Ala.; John Lewis, D-Ga.; and Patrick Meehan, R-Pa.

Read the full letter here.


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