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The Biden administration wants to change how benchmark payments to accountable care organizations are calculated to make it easier for providers in the Medicare Shared Savings Program (MSSP) to qualify for savings.
Leaders in the Centers for Medicare & Medicaid Services (CMS) outlined several changes they are pursuing to get more providers involved in value-based care in an article in The New England Journal of Medicine Thursday. CMS officials said the agency is looking into how to better calculate ACO benchmarks to better adjust for savings and to improve equity.
The goal of the reforms is to reverse a slide in participation in the Medicare Shared Savings Program—which oversees ACOs—and to target smaller providers that treat patients in underserved areas.
The Centers for Medicare and Medicaid Services announced Thursday that the professional and global Direct Contracting model will transition in 2023 to the Accountable Care Organization Realizing Equity, Access and Community Health (REACH) Model. In addition, the geographic Direct Contracting model on pause since March 2021 will be eliminated immediately.
“Under the ACO REACH Model, health care providers can receive more predictable revenue and use those dollars more flexibly to meet their patients’ needs — and to be more resilient in the face of health challenges like the current public health pandemic,” said Center for Medicare and Medicaid Innovation Director Liz Fowler in a statement.