ACOs want to be shielded from losses tied to COVID-19

ACOs and hospitals and physicians that participate in other value-based payment models are seeking to avoid the expected financial losses caused by the COVID-19 pandemic.

In a March 18 letter to House leaders, 10 trade groups representing hospitals, physicians and ACOs said they're concerned about losses they may incur that are beyond their control. 

"Congress has long encouraged clinicians and healthcare organizations to adopt a value-based approach to patient care by participating in programs such as the Medicare Shared Savings Program, advanced Alternative Payment Models … and others," the groups wrote. "Under the financial evaluation methodologies of many of these models, participants are directly responsible for the skyrocketing costs that we expect to accrue during the COVID-19 pandemic."

The potential losses are especially concerning for ACOs and advanced Alternative Payment Model participants due to upcoming program deadlines, including deadlines for risk-bearing APM participants to exit the program and avoid financial accountability for performance year 2020.

"To enable these front line clinicians and care teams to continue to focus on providing high quality, coordinated care to patients, we urge you to preclude the financial impact or shared loss repayment for all ACOs and other value based program participants based on costs accrued related to COVID-19 care and during this public health crisis," the letter states.

Here are the 10 groups that signed the letter:

  • American Academy of Family Physicians
  • American College of Physicians
  • American Hospital Association
  • American Medical Group Association
  • America's Essential Hospitals
  • Association of American Medical Colleges
  • Federation of American Hospitals
  • Health Care Transformation Task Force
  • Medical Group Management Association
  • National Association of ACOs

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