Dive Brief:
- The American Hospital Association is urging CMS to make changes in the Pioneer Accountable Care Organization Model and the Medicare Shared Savings Program.
- In a letter to CMS, the AHA complains that the two programs "place too much risk and burden on providers with too little opportunity for reward in the form of shared savings."
- In its comments, the AHA state argues that few if any additional health care organizations will choose to participate in the Pioneer ACO model as currently constructed.
Dive Insight:
Along with its critique, the AHA made several suggestions as to how to get providers to participate in accountable care voluntarily. These include partial capitation for certain services (such as Medicare Parts A or B) or partial capitation for certain beneficiaries, such as those with multiple chronic conditions. The trade group also believes that offering full capitation is important for providers capable of and willing to assume the financial risks. The bottom line seems to be that the AHA is imploring CMS to show some flexibility, or else risk losing the health care industry's interest.