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A team of health policy researchers is arguing that, in order to optimize the Medicare Shared Savings Program (MSSP), policy leaders need to think in more complex, nuanced ways about the framework and goals of the program for accountable care organizations (ACOs).
Writing in the Health Affairs Blog, Michael McWilliams, M.D., Ph.D., and Alice Chen, Ph.D. published an analytical article on November 13 entitled “Understanding The Latest ACO ‘Savings’: Curb Your Enthusiasm And Sharpen Your Pencils—Part 2.” In that article, the researchers state that, “To achieve the MSSP’s long-term goals as the centerpiece of payment reform in the traditional Medicare program, significant design changes are needed. Below, we discuss those we believe will be most decisive in achieving success. We assume that the program will remain voluntary but note that the distinction between voluntary and mandatory is not as dichotomous as the debate over alternative payment models might suggest,” they note. “Short of a mandate, participation in the MSSP becomes de facto mandatory when the fee-for-service alternative becomes sufficiently less attractive. Accordingly, our recommendations consider effects on participation among the factors CMS must weigh as it walks the regulatory tightrope strung by the MSSP; we also assume that striking the right balance in tradeoffs between savings and participation incentives should get easier with each step, as fee-for-service becomes increasingly less appealing.”