Healthcare organizations ask CMS to push back application deadline for overhauled MSSP 

Hospital finance
Several healthcare groups have asked CMS to push back the application date for its overhauled ACOs. (Getty/utah778)

Big-name healthcare organizations are asking CMS to push back the application deadline for its new accountable care organizations, allowing interested providers more time to account for complex changes. 

The Centers for Medicare & Medicaid Services is accepting applications for its revamped Medicare Shared Savings Program—called Pathways to Success—through Feb. 19. In the letter (PDF), groups including the American Hospital Association, American Medical Association and the Health Care Transformation Task Force warn that, for many ACOs, meeting that deadline “will be challenging, if not impossible.” 

“Many existing ACOs, and those in the process of formation, are still actively working to understand how they may successfully participate in the program,” the groups said. “Additional time is needed to ensure ACOs may evaluate their options and complete the administrative and legal requirements of the application.” 


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CMS finalized changes to MSSP in December, with the goal of pushing providers into taking on additional risk more quickly. The overhauled program splits new applicants into low- and high-revenue designations, which determine how long they have to take on greater risk; low-revenue participants have three years, while high-revenue have two. 

Current MSSP providers looking to renew participation will have one year to take on additional risk. 

RELATED: ACOs should plan for shorter path to greater risk in CMS’ overhauled MSSP 

In the letter, the groups say that a March 29 application deadline will allow interested providers to more effectively ensure other ACO participants, like skilled nursing facilities or independent doctors, would be on board.  

Plus, potential applicants need more time to do needed actuarial analysis and work with financial organizations on guarantees, a particular challenge as many of these financers are unfamiliar with the program. 

As MSSP is a voluntary payment model, the short application window may preclude interested parties from participating altogether, the groups said in the letter. 

“Our recommendation reflects our unified desire to see the MSSP maintain long-term sustainability necessary to enhance care coordination for millions of Medicare beneficiaries, lower the growth rate of healthcare spending and improve quality in the Medicare program,” the groups said. 

RELATED: Proposed rule changes to ACO program are ‘deal breakers,’ NAACOs says 

An October survey from the National Association of ACOs another group signed on to the letter, found that about half of current MSSP participants would continue in the updated program. The condensed timetable is the greatest concern, as NAACOs supports greater risk-sharing, it said. 

A bipartisan group of legislators has also asked CMS to rethink its timetable for participants to take on greater risk. 

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