Impatient with the conservative participation in its Medicare Shared Savings Program, the Centers for Medicare & Medicaid Services has proposed an overhaul of its most popular accountable care organization structure.
Currently, ACOs can have up to six years without taking on risk, while being granted waivers from certain federal requirements. The new proposal would shorten that window to two years for basic plan participants. The proposal also would offer greater rewards for ACO physicians using tele-medicine.
Officials said the new “Pathways to Success” program is a stride toward “greater accountability” and “new flexibilities.”
They projected it would save the Medicare program $2.2 billion over 10 years.
“The time has come to put real ‘accountability’ in accountable care organizations,” CMS Administrator Seema Verma said during the unveiling Aug. 9. “Medicare ACOs do not currently face any financial consequences when costs go up, and this has to change.”
The MSSP was established under the Affordable Care Act and launched in 2012. Many long-term care providers feel they are not given enough of the savings that are realized.
A government analysis of ACO performance revealed that CMS has spent an increasing amount on ACOs. This has occurred, in part, because 460 of the 561 ACOs in the MSSP program “are not taking on risk for increases in cost,” federal health officials said. They can reap bonuses but do not have to pay penalties if they do not create savings.
As part of the proposal, CMS has created a six-month extension for ACOs whose agreements are set to expire at the end of this year. CMS is accepting comments on it through mid-October.
From the September 01, 2018 Issue of McKnight's Long-Term Care News
