Physician-led ACOs need more help transitioning to downside risk, study finds

ACOs run by physicians need greater assistance from CMS, private insurers and others to take on more financial risk, according to a report from the Duke-Margolis Center for Health Policy in Washington, D.C.

The report, funded by the Robert Wood Johnson Foundation, found that under recent policy changes, all types of ACOs are absorbing more financial risk and achieving net savings, on average. However, it's challenging for smaller ACOs led by physicians to stay in the program longer.

Researchers found through interviews with physician-led ACOs that the organizations are worried about meeting new requirements under Medicare's Pathways to Success rule that increases financial risk for participating ACOs. Assistance with startup funding, technical operations and simplified reporting rules could help with this transition, the researchers said. 

"While CMS has provided special considerations for smaller physician-led ACOs in these reforms, the researchers contend that smaller ACOs would benefit from additional support in making the transition to taking on more financial risk," according to a news release. 

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