Providers press CMS to extend deadline on whether an ACO can quit to Oct. 31

A financial chart
Provider groups say accountable care organizations should be given an option on how to handle repaying losses to Medicare for not meeting spending targets. (Getty/Ca-ssis)

Provider groups say accountable care organizations (ACOs) need until Oct. 31 to decide whether to leave the Medicare Shared Savings Program (MSSP) due to the COVID-19 pandemic.

Currently, ACOs have until June 1 to decide whether to terminate their contract with MSSP. But providers have been worried they could soon see an exodus of ACOs leaving the program to avoid losses, especially if the June 1 deadline holds.

But pushing back the timeline will “give ACOs more time” to understand a series of new rules to mitigate the impact of the COVID-19 pandemic, according to a letter from nine groups sent to the Centers for Medicare & Medicaid Services.

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The letter added that the new deadline would help provide ACOs with more time and data “given a potential resurgence of the virus this fall.”

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The National Association of ACOs, the American Medical Association, the American Academy of Family Physicians and the Association of American Medical Colleges were among the groups that signed on to the letter.

CMS released a rule May 8 with a series of changes to MSSP, including canceling the 2021 application cycle to give ACOs “whose participation is set to end this year the option to extend for another year,” according to a release from the agency.

But the letter said that decision should be reversed, because many clinicians and healthcare organizations have already been preparing to enter the program next year.

“At a minimum, we urge CMS to implement an application period for an abbreviated participation year, beginning no later than July 2021, as the agency has previously done,” the letter said.

The providers also want help mitigating any financial losses due to COVID-19.

An ACO must meet specific spending targets and gets a share of any savings but must repay Medicare for any losses.

RELATED: CMS lays out regulatory relief for value-based care programs amid COVID-19 pandemic

CMS should give ACOs an option to be protected from any financial losses for a reduced shared savings rate of no less than 40%, the groups said.

“Many ACOs remain concerned about the unpredictability and potential for catastrophic losses for performance year 2020. Providing the flexibility of this option would prevent ACOs from quitting and maintain the savings they generate for Medicare,” the letter said.

CMS also needs to pay any ACO shared savings payments or advanced payment model bonuses as soon as possible. Typically, CMS distributes the payments in late summer or early fall, but organizations need those funds now to help deal with a major revenue hit from COVID-19.

Healthcare organizations have been hit hard by declining patient volumes and the cancellation of elective procedures.

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