Medical Shared Savings “Should I Stay or Should I Go”, Provider Groups Ask for More Time

Provider groups say accountable care organizations (ACOs) need until October 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. 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 (CMS).

Letter to CMS

As described by Fierce Healthcare, 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.

“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 must act now to retain physicians and hospitals who have committed to accountable care and the transition to value, especially those that have assumed high levels of risk. Implementing the recommendations above will help ensure the future of ACOs and value-based care overall. As physicians and hospitals are focused on defeating COVID-19 and using every resource at their disposal to do so, we urge CMS to also use every opportunity at its disposal to ensure COVID-19 does not derail the ACO and value movement. As our nation and healthcare system recover from this pandemic, we will need ACOs more than ever,” the letter concludes.