NAACOS: National Association of ACOs

Compared with other payment models, like bundled payments or the Comprehensive Primary Care Program, accountable care organizations (ACOs) have done a better job of saving money, said Rob Mechanic, MBA, senior fellow at the Heller School of Social Policy and Management at Brandeis University and executive director of the Institute for Accountable Care.

The way accountable care organizations are set up makes them a perfect system of care for high-need, high-cost patients who might otherwise fall through the cracks of traditional delivery models, said Rob Mechanic, MBA, senior fellow at the Heller School of Social Policy and Management at Brandeis University and executive director of the Institute for Accountable Care.

There are some proposed changes to the Medicare Shared Savings Program (MSSP) that may be favorably or not depending on the accountable care organization (ACO) and its situation, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

The way Washington, DC, works will make it difficult to enact any meaningful change that will cause a difference in how much patients pay for prescription drugs, said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

There remain issues with benchmarking, attribution, and risk adjustment that CMS needs to address with accountable care organizations (ACOs), said Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System.

The shorter timeline to risk and the reduction of shared savings rates are among the 2 greatest challenges accountable care organizations (ACOs) will face as part of the proposed changes to the Medicare Shared Savings Program (MSSP), said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

While the proposed changes to the Medicare Shared Savings Program (MSSP) won’t mean a large number of changes to Coastal Carolina Quality Care, the accountable care organization will have to make some changes to respond to the new Enhanced track, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

One of the big issues that policy makers need to pay more attention to is how to reform Medicare, which has about 10 years remaining until the baby boomers aging into the program now start to see increased medical costs and needs, said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

There are different ways to measure how Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) have saved money, and the way used can drastically affect the amount of savings reported, explained Clif Gaus, ScD, president and CEO of the National Association of ACOs.

Systems, groups, and practices that haven’t yet joined the accountable care organization (ACO) movement will find it harder to do so if the proposed changes to the Medicare Shared Savings Program (MSSP) take effect, said Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System.

The push to get accountable care organizations to take on risk faster could lead to more participation in Medicare Advantage, said Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System.

CMS’ proposed changes to the Medicare Shared Savings Program (MSSP) doesn’t represent a major shift in policy stance toward accountable care organizations (ACOs), said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

By encouraging more providers to take on risk faster, the current administration may actually be disincentivizing providers from participating at all, which would reduce the number of accountable care organizations (ACOs), said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

The proposed changes to the Medicare Shared Savings Program that move accountable care organizations (ACOs) to take on risk in just 2 years is not going to be enough time for most ACOs, although some may be ready in that time, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

During the opening plenary and panel at the fall 2018 meeting of the National Association of ACOs (NAACOS), Adam Boehler, of the Center for Medicare and Medicaid Innovation, highlighted the fact that CMS has to provide predictability and simplicity to get more accountable care organizations to take on risk and succeed, but that those who are not "cutting it" should "get out of the way" for others.

Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System, discusses how Mount Sinai’s accountable care organizations (ACOs) will have to adjust to the proposed CMS Medicare Shared Savings Program (MSSP) changes.

Accountable care organizations (ACOs) are of 2 minds right now. On the one hand, there is a lot of excitement for the future of ACOs, but there is also great anxiety around the changes that CMS proposed for the Medicare Shared Savings Program (MSSP), said Clif Gaus, ScD, president and CEO of the National Association of ACOs (NAACOS).

Accountable care organizations (ACOs) often care for patients with complex, chronic conditions that can lead to high expenditures and utilization of care. During a session at the National Association of ACOs Fall 2018 conference, being held October 3-5 in Washington, DC, panelists discussed how ACOs can design and implement strategies that deliver high-quality, low-cost care for these patients.

The proposed CMS regulation to change the Medicare Shared Savings Program (MSSP) so that accountable care organizations (ACOs) take on risk faster creates a one-size-fits-all model that doesn’t allow for variability, said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

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