The CMS is proposing changes to the way it evaluates whether accountable care organizations in the Medicare Shared Savings Program actually save money.
The CMS wants to move away from assessing ACO benchmarks based on historical spending, and instead analyze trends in regional fee-for-service costs.
“Medicare payments are an important catalyst to improving care delivery, spending our resources smarter and keeping people healthy," Andy Slavitt, acting administrator for the CMS said in a statement. "This proposal allows ACOs in all parts of the country to be successful by recognizing both their achievements and improvements in how they provide care."
Slavitt added that he hopes the proposed changes will grow the number of ACOs and their model of coordinated care.
The proposed evaluation changes would result in $120 million in net federal savings between 2017 and 2019, according to the CMS.
Benchmarking has been a sore spot for ACOs, industry insiders say. There is a feeling that the current methodology is unfair, and effectively punishes high-performing ACOs, according to April Wortham Collins, manager of customer segment analysis for Decision Resources Group, a healthcare consulting firm.
Specifically, ACOs have said they haven't been able to share in savings, Collins said in an analysis on the issue. Or, if they do get some sort of payout, it's a small amount. Under the ACO model, program results are measured against an annual cost target, instead of on year-over-year improvement. Using this method, healthcare systems with high baseline costs have a lot of room for improvement, while those with low baseline costs do not.
Comments on the proposal are due by April 3.
