Providers want more flexibility in Medicare Shared Savings Program
A coalition of 33 provider-side organizations is calling on the Centers for Medicare & Medicaid Services (CMS) to create better incentives for participation the Medicare Shared Savings Program (MSSA).
In a letter to departing CMS Administrator Marilyn Tavenner, the groups, including the American Medical Association, Federation of American Hospitals, Medical Group Management Association, Trinity Health, the Premier healthcare alliance and numerous specialty societies, seek waivers for ACOs to move to higher-risk tracks of the MSSP, among other changes.
If the Department of Health and Human Services (HHS) is to realize its recently announced goal of having at least 50 percent of Medicare fee-for-service reimbursements tied to ACOs and other new payment models by 2018, there need to be better incentives for providers to stay in the program, the groups contented.
“In order for HHS to meet its goals and ensure continued and enhanced participation in the MSSP, we urge CMS to: strengthen the assignment of Medicare beneficiaries, establish a more appropriate balance between risk and reward, adopt payment waivers to eliminate barriers to care coordination, modify the current benchmark methodology and provide better and timelier data,” they wrote in boldface type.
In the first year of the program, a slim majority of participating ACOs saved Medicare money, but just 26 percent actually qualified to share in the savings, according to the letter. “As currently designed, the MSSP program places too much risk and burden on providers with too little opportunity for reward in the form of shared savings,” the letter said.
“While the MSSP program has generated strong interest, sustained and increased participation hinges on the potential financial opportunities being adequate to support the investments needed to improve care and, ultimately, create a program that is sustainable for the long term.”
For more, read the short form of the letter, signed by 33 groups, or a longer version, with 16 signatories.
Neil Versel joined TriMed in 2015 as the digital editor of Clinical Innovation + Technology, after 11 years as a freelancer specializing in health IT, healthcare quality, hospital/physician practice management and healthcare finance.