- CMS has published a proposed rule to change how it evaluates accountable care organizations (ACOs) in the Medicare Shared Savings Program.
- CMS hopes to determine whether the ACOs are actually saving money, Modern Healthcare reported.
- Some of the proposals include recognizing trends in health costs vary in different communities, and streamlining how ACO benchmarks are adjusted when their composition changes.
“Medicare payments are an important catalyst to improving care delivery, spending our resources smarter and keeping people healthy," CMS Acting Administrator Andy Slavitt, said in a prepared statement. "This proposal allows ACOs in all parts of the country to be successful by recognizing both their achievements and improvements in how they provide care."
Slavitt hopes the proposed evaluation changes will result in an increase in the number of ACOs and their coordinated care model.
Included in the proposed rule: All eligible ACO beneficiaries would be used as the foundation for progam calucations using national and regional FFS spending. In addition, the definition of an ACO's regional service area was proposed to include any county where at least one assigned beneficiary lives.
"The rule calls for an ACO's rebased benchmark to be adjusted when it enters a second or subsequent agreement period," Becker's Hospital Review reported. "Under the proposed rule, the benchmark would be adjusted by a percentage of the difference between fee-for-service spending in the ACO's regional service area and the ACO's historical spending."
According to CMS, the changes would result in $120 million in net federal savings from 2017 to 2019.
CMS will take public comments on the proposed rule by March 28.