5 Changes To Help Medicare ACOs Thrive
Posted on Tuesday, April 14, 2015 10:35 AM
In order for the Medicare Shared Savings Program to reach its full potential, some key changes must be made, according to the authors in a recent Health Affairs blog post
. Medicare ACOs have made progress on care quality and patient experience, however, only 1 in 4 MSSP ACOs have cut spending enough to share in overall savings.
According to authors in Health Affairs
, the Medicare Shared Savings Program needs to make the following changes to truly thrive:
- Increased certainty: A major issue with MSSPs is uncertainty. In order to correct this, CMS should transition to a benchmark calculation formula that combines ACOs’ historical spending and regional spending to eventually transition to a benchmark based completely on regional spending.
- Clear definition of the transition away from fee-for-service: CMS should drive the transition with incentives greater than those for fee-for-service for organizations that demonstrate reduced costs and improved quality.
- Alignment of MSSP with other Medicare reimbursement programs: In order to get MSSP and other Medicare alternative payment models on the same page, the authors recommend risk adjustment calculations, reporting mechanisms and requirements, and consistent quality measures.
- Patient engagement: ACOs need more support to communicate and engage with their patients. The authors suggest expanding CMS’ pilot program for Pioneer ACOs’ “attestation models.”
- Use of pointers from commercial ACOs: Many ACOs in the private sector have seen more success than those under Medicare by shifting away from fee-for-service with limited financial risk. CMS “should seek to reinforce those successful steps.”
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