Nine industry groups have joined in opposition to CMS’s proposed changes to the Medicare Shared Savings Program.
The changes, proposed in August, would force accountable care organizations to take on downside financial risk in just two years. Currently, ACOs—82 percent of which do not take downside risk—have six years in the shared savings program before they must assume downside risk. In addition, the proposal slashes shared savings rates in half for ACOs, from 50 percent to 25 percent.
Opponents of the proposals argue the changes will cause many ACOs to leave the voluntary program. Since 2012, the number of ACOs participating in the shared savings program has grown from 27 to 561, covering more than 10.5 million Medicare beneficiaries.
The American Medical Association (AMA) and America’s Health Insurance Plans (AHIP), along with the National Association of ACOs (NAACOS) and six other organizations penned a letter to CMS Administrator Seema Verma, warning that the unintended consequences of the changes could undermine the broader shift toward value-based care.
“Specifically, we are very concerned with shortening the time new ACOs have in a shared savings only model from six to two years and cutting in half the shared savings rates for these ACOs from 50 percent to 25 percent,” the letter reads.
Data analysis also reveals that ACOs tend to do better over time with respect to meeting the savings goals of the program. Two years may not be enough time for a new ACO to ramp up, opponents contend.
“ACOs have been instrumental in the shift to value-based care and a central part of the ACO concept is to transform healthcare through meaningful clinical and operational changes to put patients first by improving their care and reducing unnecessary expenditures,” the letter reads. “These transformations are significant and, as such, require time for implementation and to produce measurable results.”
The groups urged CMS to keep the shared savings rate at 50 percent and allow more time for ACOs to operate in an upside-only model.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."