A recent survey of risk-based accountable care organizations found 56% are likely to leave the program due to concerns about having to repay losses stemming from the COVID-19 outbreak.
The survey released Monday by the National Association of ACOs comes as healthcare facilities are struggling to stay afloat due to financial pressures from the outbreak. Risk-based ACOs also have a major deadline of May 31 to give notice to the Trump administration to avoid paying losses or get any shared savings.
“Medicare’s decade-long effort to change how we pay for health care to better reward quality and outcomes may be lost unless Washington acts quickly to throw these providers a lifeline,” said NAACOS president and CEO Clif Gaus.
ACOs that take on financial risk must repay Medicare if they don’t meet spending targets but get a share of any savings they produce.
But 77% of ACOs surveyed say they are very worried about the impact of the outbreak on their 2020 performance.
The survey also found that 21% of ACOs that take on financial risk are very likely to leave the program, as well as 14% as likely and 21% as somewhat likely.
The reason for the departures is that COVID-19 “has upended normal utilization and care patterns, disrupting ACOs’ ability to employ successful population-health strategies and causing tremendous uncertainty about costs,” the survey said.
A large majority (65%) also said that it is going to be very difficult to accurately predict their 2020 performance.
The COVID-19 outbreak comes as ACOs are already being pushed to take on more financial risk by the Centers for Medicare & Medicaid Services. As of January, there are 558 ACOs that serve more than 12.3 million people in Medicare, NAACOS said.
But NAACOS has previously been concerned that the push for ACOs to take on more financial risk could drive providers out of the program or cause some to not enter.
CMS has stepped in to provide some regulatory relief for ACOs and other value-based programs.
The agency will not use quality data on services provided from Jan. 1 through June 30 in any calculations for quality reporting and value-based purchasing programs. CMS also pushed back deadlines for the Merit-based Incentive Payment System and MSSP to submit 2019 data as to not overburden providers on the frontlines.
However, NAACOS and several provider groups have called for CMS to waive any performance results and quality scores for all of 2020 for ACOs and other providers in alternative payment models.
The survey results are based on 304 responses from 226 ACOs across the country, NAACOS said.