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Last week CMS released a proposed rule addressing revisions in the Physician Fee Schedule (PFS) and the Quality Payment Program (QPP), along with a few other matters. Of 1,704 pages, only about 20 addressed ACOs issues directly. But ACOs should take a holistic approach to reading this proposed rule, as well as the proposed Outpatient Prospective Payment System (OPPS) rule.
Competition Among Risk Models Will Strongly Affect the Course of Change
With so many CMS programs and models now in flux, the whole is more than the sum of its parts. It’s worth the effort to pay attention to the systematic interweaving of proposed changes throughout the various programs. That’s because CMS’s position is clarifying the direction and makeup of Medicare’s Value-Based Health Care program. ACOs, once considered “the” direction for Medicare Value-Based Health Care, will be just one of several options for new Medicare risk-based models. Medicare Advantage (MA) plans—the option that is repeatedly praised by CMS—Direct Contracting (DC) physician practices, Primary Care First (PCF) practices, and various types of ACOs will be competing for both physicians and patients.