- A nonprofit industry consortium is urging CMS to begin soliciting 2019 applications from accountable care organizations for the Medicare Shared Savings Program, saying further delays could hurt progress in the move to value-based care.
- In a letter to CMS administrator Seema Verma, The Healthcare Transformation Task Force said the fact that no solicitation has been issued this year puts the program well behind the past four years when ACO applications for the following year were due by July 31.
- The group suggests the holdup may be tied to a proposed rule on MSSP ACOs, which has been pending at the Office of Management and Budget since early May. If that’s the case, CMS should move ahead with the 2019 application period under the status quo and finalize the regulation later, HTTF said.
MSSP has shown promise, and ACOs are joining up, though most are not eager to take on risk. In a recent National Association of ACOs (NAACOs) survey, 71% of ACOs said they will exit the program next year if forced to assume risk. About 6% said they weren't sure what they would do, while 23% said they would likely stick with the program.
Under the Affordable Care Act, ACOs that entered MSSP Track 1 in 2012 or 2013 are expected to shift to a risk-based model in their third contract period, which begins next year.
Regulatory delays and other red tape won’t help this, or any, CMS-led value-based effort.
HTTF — whose members include providers, payers, patients and purchasers — said the holdup caused “great concern” at its board of directors meeting in Chicago earlier this month.
“Even if eventually there is a solicitation for 2019 applications the ongoing delay is likely to impact the volume of new ACO participants for 2019 as well as the number of 2016 ACOs that may choose to renew for another contract period,” according to the letter. “Given the growth and momentum of the MSSP program, this limbo is causing great concern and consternation.”
HTTF is not alone in questioning CMS’ silence on MSSP ACO participation. In a June 19 letter to Verma, the NAACOs expressed “significant concern with the lack of information … regarding the application process for ACOs interested in applying for the 2019 Medicare Shared Savings Program.”
ACOs are concerned not just about whether there will be a 2019 program start, but whether any timelines will allow time to analyze program changes and review and prepare applications.