Nine healthcare organizations—including the American Medical Association (AMA) and America's Health Insurance Plans (AHIP)—are asking the federal officials to scale back proposed changes the Medicare Shared Savings Program.
In a letter (PDF) to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, the groups urged the agency to give accountable care organizations more time to participate in the federal program and maintain their 50% cut in shared savings.
A proposed rule released last month would reduce the amount of time ACOs can be in the programs upside only track from down from six years to two. It would also cut the shared savings rate to 25%.
RELATED: CMS pushes ACOs to take on more risk with Medicare Shared Savings Program overhaul
The National Association for ACOs (NAACOS), which has led the charge in resisting CMS' proposed changes, was among the organizations that signed the letter. But NAACOS was joined by several prominent physician groups including the Association of American Medical Colleges (AAMC) the American College of Physicians (ACP) and the Medical Group Management Association (MGMA).
The organizations argued that the proposed changes "would have unintended consequences of undermining the broader shift to value-based care," pointing to recent research that shows ACOs saved Medicare $1.8 billion between 2013 and 2015 , nearly twice as much as CMS calculated. Data released by CMS last month shows ACOs saved $314 million in 2017 after accounting for shared savings payments.
RELATED: CMS data shows ACOs saved Medicare $314M in 2017
Moreover, ACOs have said they will leave the program if they are forced to take on more risk. Verma has said the agency only wants to work with providers that "are serious about delivering value."
"The MSSP remains a voluntary program, and it’s essential to have the right balance of risk and reward to continue program growth and success," the organizations wrote. "Program changes that deter new entrants would shut off a pipeline of beginner ACOs that should be encouraged to embark on the journey to value, which is a long-standing bipartisan goal of the Administration and Congress and important aspect of the Quality Payment Program."
While the nine organizations bring an outsized influence, several notable experts supported the proposed rule that would force ACOs to take on more financial risk. The letter also comes as 29 Next Gen ACOs announced a new coalition focused on furthering higher-risk arrangments.
Jeff Micklos, executive director of the Health Care Transformation Task Force, previously told FierceHealthcare the rule would "separate the wheat from the chaff," adding that allowing one-sided ACOs to "hang around for six years or even longer really just seems counterintuitive to us."
HCTTF was among the nine groups to sign the letter, in part because the language was fluid enough not to put a time frame on how long ACOs should remain in one-sided models. Micklos told FierceHealthcare his organization has been supportive of three years in an upside-only model, but the sticking point for them is reducing shared savings to 25%.
"Given the level of investment, that would be a turn off for some organizations," he said.
