Moving accountable care organizations (ACOs) to Medicare Shared Savings Program (MSSP) tracks with downside financial risk may not help the accountable care initiative generate savings, according to a new analysis from the Center for Healthcare Quality and Payment Reform (CHQPR). The study found that CMS spends more per beneficiary in ACOs with downside risk compared…
Last week the conversation about financial risk for providers in ACOs took on a decidedly different and more contentious tone. After months of CMS reports of ACO growth and success, while retreating on MIPS quality reporting requirements as concessions to “provider burden,” CMS signaled that they were finished waiting for providers to accept financial risk…
Ann Morse Abdella was all in when the Medicare Shared Savings Program started in 2012. She helped launch a rural accountable care organization in western New York, serving roughly 7,000 Medicare beneficiaries. Six turbulent years later, Chautauqua Region Associated Medical Partners is heading for the exit. The constantly evolving program and its increasing pressure to…
Medicare accountable care organizations (ACOs) are likely to face an imminent overhaul, according to former leaders of the program. Nancy-Ann DeParle, partner with Consonance Capital and formerly acting administrator of the predecessor agency to the Centers for Medicare & Medicaid Services (CMS) before serving as an Obama White House senior healthcare adviser, said CMS is…
UnityPoint Health’s participation in the initial rollout of CMS’ Next Generation ACO Model helped them succeed beyond their expectations in their transition to reimbursement risk. In performance year 1 (2016), UnityPoint’s 85,000-member Iowa Health ACO earned more than $10.5 million in shared savings. Like most health systems, UnityPoint still gets more revenue from fee-for-service than…
Most accountable care organizations say they will disband if the CMS forces them to take on financial risk next year. ACOs that started in the Medicare Shared Savings Program (MSSP) Track 1 in either 2012 and 2013 are supposed to move to a risk-based model by their third contract periods which begin next year, according…
Track 3 and NextGen ACO’s have to demonstrate that they would be able to repay shared losses incurred at any time within the agreement period, and for a sufficient period of time following the end of each agreement period (the “tail period”), to permit CMS to calculate the amount of any shared losses that may…
Medicare Shared Savings Program (“MSSP”) Track 1+, Track 2 and Track 3 ACOs, and NextGen ACOs, have two-sided risk. CMS requires these ACOs to provide a repayment mechanism to assure that shared losses can be repaid. Depending on its track, an ACO’s repayment mechanism equals 1% or 2% of the ACO’s total per capita Medicare…
Dive Brief: Provider organizations are urging CMS to allow Medicare accountable care organizations (ACOs) to continue for three more years without taking on financial risk. Under the Medicare Shared Savings Program (MSSP), ACOs that began in 2012 or 2013 face their third contract period in 2019 and will have to move from Track 1 to…
The National Association of ACOs, the American Medical Association (AMA) and others have jointly signed a letter requesting that CMS (the Centers for Medicare & Medicaid Services) allow certain ACOs to continue in the Medicare Shared Savings Program (MSSP) Track 1 for a third agreement period before having to move to a two-sided risk model….