Shared Savings Program ACOs wary as CMS halts pay models
Read Article: Modern Healthcare
Article Summary: The future of the Medicare Shared Savings Program (MSSP) is uncertain as the Trump administration puts its stamp on Medicare policy. Stakeholders in Accountable Care Organizations (ACOs) are concerned about potential changes, especially after the Centers for Medicare and Medicaid Services (CMS) ended four smaller Medicare payment models early. While ACOs have been successful in reducing spending and improving quality, the Trump administration has shown interest in scaling back or even ending MSSP, citing a lack of sufficient cost savings. The program may face modifications that could reduce participation or scope, particularly regarding the risk arrangements for providers.
The Risk:
Risk of Medicare Program Shifts or Elimination: The Trump administration could decide to scale back or end the Medicare Shared Savings Program, which may leave ACOs without the financial incentives and structure they rely on to improve patient outcomes while reducing costs. If the program is modified or eliminated, providers may face financial instability and a loss of current incentives.
Participation Decline in Risk-Based Models: The implementation of stricter risk models (e.g., requiring more two-sided risk arrangements) could discourage healthcare providers from participating in the MSSP, especially those who are not ready to accept increased financial responsibility. This could lead to a reduction in ACO participation, limiting the reach of the program and diminishing its effectiveness.
Uncertainty in Payment Models: The uncertainty around Medicare payment models, including potential cuts or restructuring, creates instability for healthcare organizations that rely on these models for funding. ACOs may find it challenging to plan long-term strategies if the payment structures remain unclear or subject to rapid changes under the current administration.