Among the dozen revisions to the Medicare Shared Savings Program being considered includes one that could bring some relief to accountable care organizations facing penalties for poor performance.
Among the dozen revisions to the Medicare Shared Savings Program (MSSP) being considered includes one that could bring some relief to accountable care organizations (ACOs) facing penalties. CMS proposed that ACOs with poor performance would have 3 extra years before they could be punished.
The rule would affect the more than 330 ACOs providing care for 5 million individuals through the MSSP. According to Kaiser Health Network, the revision is intended to entice the formation of new ACOs and keep participating ACOs in the program.
“This proposed rule is part of our continued commitment to rewarding value and care coordination—rather than volume and care duplication,” CMS Administrator Marilyn Tavenner said in a statement. "We look forward to partnering with providers and stakeholders to continuously refine and improve the Medicare Shared Savings program.”
The MSSP currently has 2 options: Track 1 is a one-sided shared savings only model for a 3-year agreement period, and Track 2 is the two-sided shared savings/losses model for a 3-year agreement period. ACOs participating in Track 1 must switch to Track 2 after the initial 3 years.
However, ACOs can now receive an additional 3 years, for a total of 6 years, before they face financial penalties by renewing their agreement under Track 1. There is a downside to choosing this option: ACOs that choose to receive the extra 3 years before being penalized for poor performance will not be entitled to as much of the shared savings. Instead of being able to keep up to 50% of the money the ACO saved Medicare, participants that delay penalties for the 6 years will only be able to keep up to 40% of savings.
Furthermore, CMS is proposing a Track 3 that would allow participants to keep up to 75% of shared savings. The ACOs in the Pioneer Model, which ends in 2016, would move over to the new model, which has similar rules.
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
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen
Covered Preventive Services at Risk: V-BID Summit Breaks Down the Braidwood v Becerra Case
March 20th 2024For more than a decade, certain high-value preventive care services have been covered at no cost to patients under the Affordable Care Act, but a current legal challenge has the coverage at risk.
Read More
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