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Now that the Biden administration is putting a new team in charge of CMS, advocates for accountable care organizations (ACOs) are preparing to push for changes that they say will bolster CMS’ ACO programs and make risk sharing more palatable.
The National Association of ACOs (NAACOS) says that ACOs have worked as intended to slow the rate of spending growth for the Medicare program. In January, the group put out a statement saying that the new administration should increase what CMS pays hospitals, health systems and physician groups that participate in the Medicare Shared Savings Program (MSSP) and give them more time to take on downside risk. NAACOS noted that number of ACOs participating in MSSP, the largest CMS ACO program, has dropped from a high of 561 in 2018 to 477 this year. NAACOS says that MSSP deserves credit for being CMS’ largest, most successful value-based program. NAACO President and CEO Clif Gaus, Sc.D., says making the incentives to participate more attractive and the risks more manageable would lead more provider groups to participate. NAACOS has proposed that shared savings be split 50-50 between CMS and the ACOs instead of the current 60-40 ratio. The organization also wants an on-ramp of three years before shared savings starts. “Our healthcare payment and delivery system needs to desperately change, and ACOs offer the leading way to make that happen,” Gaus says. “A steady erosion of ACO participation damages our ability to get to where we need to be.”