Coordinated care groups that are struggling to take on financial risk are unlikely to find a saving grace from the Trump administration.
Early this week, Centers for Medicare & Medicare Services (CMS) Administrator Seema Verma made it clear that nonrisk-based ACOs aren't saving enough money and a greater push to take on risk is necessary.
"The majority of ACOs, while receiving many waivers of federal rules and requirements, have yet to move to any downside risk," Verma said Monday at the American Hospital Association annual membership meeting. "And even more concerning, these ACOs are actually increasing Medicare spending, and the presence of these 'upside-only' tracks may be encouraging consolidation in the marketplace, reducing competition and choice for our beneficiaries."
She added, "While we understand that systems need time to adjust, our system cannot afford to continue with models that are not producing results."
The National Association of Accountable Care Organizations, along with other groups, have pleaded to the agency that some providers are not yet ready to enter risk-based arrangements.
Verma's comment follows a recent survey that found 71% of ACOs that will be forced into risk-based tracks due to contract limits are likely to leave the program starting next year.
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Verma appeared to either be calling their bluff or suggesting ACOs won't be helpful in moving the healthcare sector towards more value-based care.
A proposed rule on the program still waits for review at the Office of Budget and Management. It appears increasingly unlikely that it will be a saving grace for struggling ACOs.