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.
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.
Transcript
How do you think pushing more accountable care organizations (ACOs) to take on risk faster will impact participation in the MSSP?
I’m concerned about the new CMS regulation, because it’s not at all clear that giving ACOs 5 years, I believe it is, and you’re either successful or you’re out, necessarily makes sense. There’s a lot of variability in healthcare. That’s the problem. And there’s a lot of variability geographically, and a whole bunch of other factors are at work as well.
So, this one-size-fits-all—which, unfortunately, is pretty much the only way the government can set a rule—makes it difficult. I think, in the end, what people have predicted will probably come true, but it might be transitory. I think there will be ACOs who are now in the program who will drop out. There will be some discouragement factor there. Not as many organizations will try to become an ACO, until the kinks are worked out. I think that’s the issue. Because it’s not just “there’s a rule.” It’s, “well, how does CMS actually implement it and are there ways to deal with whatever the hard barriers are?” These are businesses—they’ll find ways.
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Reducing Low-Value Care Is Hard, but What About Just Not Paying for It?
March 14th 2024After years of efforts to reduce low-value care, panelists at the 2024 Value-Based Insurance Design Summit proposed a new strategy: drawing a line in the sand that payers will not be on the hook for these services.
Read More
Oncology Onward: A Conversation With Penn Medicine's Dr Justin Bekelman
December 19th 2023Justin Bekelman, MD, director of the Penn Center for Cancer Care Innovation, sat with our hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, for our final episode of 2023 to discuss the importance of collaboration between academic medicine and community oncology and testing innovative cancer care delivery in these settings.
Listen
Fragmented Payer System, Vulnerable Supply Chain Among Threats to Accessing Essential Medicines
March 13th 2024During a session of the 2024 V-BID Summit, panelists Stacie Dusetzina, PhD, and Inma Hernandez, PharmD, PhD, discussed how access to essential medications is curtailed not just by the longstanding complexities of insurance design but also by emerging threats such as supply chain weaknesses and cyberattacks.
Read More