AHA: Medicare ACO program is too much risk, not enough reward

The American Hospital Association penned a comment letter last Thursday calling on CMS to make changes to its December 2014 proposed rule for the Medicare Shared Savings Program.

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AHA believes accountable care organizations in the program should be able to share in more of their generated savings to support coordinated care.

“As currently designed, and as proposed in this rule, the MSSP applies too many ‘sticks’ and offers too few ‘carrots’ to participating providers and, possibly, to those entities contemplating MSSP participation. In other words, the MSSP places too much risk and burden on providers, with too little opportunity for reward in the form of shared savings,” the letter reads.

The letter included the following five main suggestions.

  • Allow ACOs to take on more risk at their own pace.
  • Put an increased emphasis on primary care in driving the beneficiary assignment process and give ACOs more assignment options to better match appropriate services to targeted beneficiaries.      
  • Permit specific payment waivers to streamline coordination, like the skilled-nursing facility three-day stay rule, for example.
  • Adjust performance metrics to account for regional cost differences and past performance.
  • Establish a system to provide real-time data to ACOs.

Read the full letter and detailed suggestions here.

 

More articles on accountable care:

22 recent accountable care agreements
The new “ACO-enabling organization” in Texas
ACOs need to focus on specialty care to effectively achieve savings, study shows

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