Lawmakers press CMS on shorter glide path, less risk-sharing for ACOs

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Nine House Representatives called on CMS to modify proposed changes to the Medicare Shared Savings Program. (Pixabay)

Nine legislators from both sides of the aisle are asking the Trump administration to reconsider changes to the Medicare Shared Savings Program (MSSP).

In a letter (PDF) to Centers for Medicare & Medicaid Services Administrator Seema Verma on Tuesday, nine representatives raised concerns about shortening the amount of time accountable care organizations can stay in a one-sided risk model and cutting the shared savings rate from 50% to 25%.

The lawmakers said it is "imperative that MSSP ACO participation remains a workable option” to move forward with alternative payments. They echoed a common argument from the National Association of ACOs (NAACOS) that changes to the program’s glide path and shared savings rate would prevent new ACOs from entering the program.

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2019 Drug Pricing and Reimbursement Stakeholder Summit

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“To ensure that ACOs have a sufficient business case to participate in this voluntary program, we urge CMS to modify these proposals in the final rule,” they wrote.

RELATED: NAACOs says ACOs saved Medicare nearly twice as much as CMS' estimates

The letter was signed by Reps. Diane Black, R-Tenn., Peter Welch, D-Vt., Suzan DelBene, D-Wash., Gene Green, D-Texas, David Roe, M.D., R-Tenn., Greg Gianforte, R-Mont., Tom Reed, R-N.Y., Brad Wenstrup, M.D., R-Ohio, and Roger Marshall, M.D., R-Kan.

“These lawmakers understand that CMS’ proposed push to risk offers too little time and not enough opportunity for ACOs to recoup investments and threatens to cut off a pipeline of providers hoping to start the transition to value-based care,” NAACOS President and CEO Clif Gaus said in a statement.

NAACOS board members have said the proposed changes are “deal-breakers” and pointed to recent research showing that downside risk ACOs have saved Medicare significant money. The group has been backed by other healthcare heavyweights like the American Hospital Association and America’s Health Insurance Plans.

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