Dr Joe Antos: Proposed MSSP Changes Not a Major Shift in Policy for ACOs

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.

If the proposed CMS changes to the MSSP are expected to make fewer ACOs participate, do you think the proposal will affect the ACO movement?
I wouldn’t say that this is a major change in policy with regard to ACOs. The current administration has clearly accepted the concept of ACOs, they’re clearly trying to promote them in a way.

I would say that Andy Slavitt, who was the CMS administrator under [President] Obama, said something to the effect of “yeah, there should be a time limit and if you’re not successful within a reasonable time limit, then you should go. Because it’s not going to work out for you.” So, I think that’s kind of a hard-eyed business look at this. But I don’t think this is a major change in policy.

They’re going to have to do other things to either strongly promote ACOs or strongly discourage them. I think one of the things that would promote ACOs or promote movement toward a more sensible approach to delivery, in general, would be to follow some of MedPAC [Medicare Payment Advisory Commission]’s suggestions with regard to fixing MIPS [Merit-based Incentive Payment System] and fixing MACRA [Medicare Access and CHIP Reauthorization Act], which is a problem all by itself.
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