CMS cancels Shared Decision Making ACO model

Too few accountable care organizations (ACOs) were interested in testing CMS’s Shared Decision Making (SDM) model, so the agency announced it wouldn’t be moving forward with the program.

The model had been announced under the previous administration in Dec. 2016. The goal was for ACOs to test how clinical practice could be adapted into a four-step decision-making process: identifying eligible beneficiaries, distributing patient decision aids, offering an in-person collaborative process to understand treatment options and then tracking and reporting outcomes.

Six conditions where clinical evidence doesn’t support one option over another would’ve been involved: table ischemic heart disease, hip osteoarthritis, knee osteoarthritis, herniated disk and spinal stenosis, clinically localized prostate cancer (cancer that is confined to the prostate gland) and benign prostate hyperplasia (BPH). ACOs which participated would have received for $50 for each decision-making service it provided.

Only ACOs participating in the Medicare Shared Savings Program or Next Generation ACO model could have applied, limiting the potential pool of SDM participants to 525 organizations. While the agency did extend the application deadline and updated documents for the program as late as September, the model was cancelled as of Nov. 14 with a short note on the CMS website.

“After careful consideration, Services (CMS) is announcing its decision to not test the Shared Decision Making (SDM) Model because an insufficient number of Accountable Care Organizations (ACOs) were interested in participating in the Model,” the agency wrote.

The other shared decision making model announced last year, Direct Decision Support, appears to be moving forward. This model involves non-providers or suppliers, providing a population-based payment to participating decision support organizations, or DSOs, in engaging Medicare beneficiaries outside of office visits. Unlike the SDM model, the application period wasn’t extended past its original Match 5, 2017 date, though no update on the program has been made since by CMS.