A group of 33 medical associations and health systems wrote a letter to CMS to urge the agency to include more patient and financial policy data in its Medicare Shared Savings Program.
The letter, which included the American Medical Association and the National Association of ACOs among its authors, responded to CMS' proposed rule from December 2014 discussing changes to the MSSP.
One of the major changes within the MSSP is to transition to a two-sided model from a one-sided model. Track 1 ACOs will be able to continue in Track 1 for more than one agreement period. The letter expressed concern that the MSSP in its current form "places too much risk and burden on providers with too little opportunity for reward in the form of shared savings."
However, besides the discussion of Medicare policies, the authors called for more data to be shared with ACOs. The letter made five major points about data:
1. ACOs need more data on their patients to best coordinate patient care. Medicare beneficiaries can seek care from any practice that accepts Medicare, and ACOs must keep track of all that data from various practices. CMS currently provides each ACO with a claims history dataset, but the authors called for more current data.
2. CMS should offer ACOs a point-of-service notification system that would alert them when a provider is checking a beneficiary's eligibility and a chance to intervene "to coordinate their care, redirect the patient to an appropriate setting or engage with healthcare providers who may not be participating with the ACO."
3. Make data on patient's primary care visits and eligibility data with ACO providers available to all tracks and on aggregate reports.
4. Remove beneficiaries who opt out of sharing data from the financial reconciliation process because ACOs will be unable to "effectively coordinate the care of these patients and should not be held financially responsible for them."
5. Provide a firmer definition of what a "regional rate" is for fee-for-service expenditures, which would be used to measure benchmark shared savings and losses under the proposed change.