ACO models pass on CMS Shared Savings Program

Most accountable care organization models are hesitant to apply for the Centers for Medicare & Medicaid Services' Medicare Shared Savings Program, according to a survey released last week from health IT nonprofit eHealth Initiative. Out of the 20 organizations who responded, half (50 percent) said they did not intend to apply for the CMS program, and another 37.5 percent were unsure; only 12.5 percent said they intended to apply.

The survey, which was conducted before and after CMS issued the final rule in October, revealed that most organizations were concerned about the final rule and whether the Shared Savings Program or the Pioneer ACO Program offered enough incentives for participation. They cited not having an opportunity to digest the rule, the final rule including major loopholes impeding success or a low Medicare patient population.

Most of the ACO models noted they were in the developmental stages; only eight organizations reported being fully operational, according to the report.

An earlier poll conducted by KPMG, Epstein Becker Green and The JHD Group found similar results. Half of senior executives at hospitals and health systems reported being unsure about whether to participate in the Medicare ACO program. Only 16 percent of leaders said they would participate in the CMS bundled payment model within the next two years, and only 14 percent plan to launch their own ACO program.

The surveys indicate that executives' concerns over the benefits of participating in CMS' programs may not outweigh the risks involved. However, as indicated by the eHealth Initiative respondents, that hasn't stopped organizations from testing out their own accountable care models, outside of the parameters of CMS.

For more information:
- read the eHealth Initiative report (.pdf)
- see the KPMG press release

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