Accountable care organizations have experienced a change of heart and say they will likely stay in the Medicare Shared Savings Program even if that means taking on downside financial risk sooner, according to an association survey released last week.
Nearly 50% of the ACOs surveyed by the National Association of ACOs said they would participate in the program if the CMS restructures it and eliminates some tracks that don't include financial risk for the organizations.
That's a stark change from the spring, when 71% of early shared-savings program adopters said that they were likely to leave the program if forced to take on risk. Now, only 36% say they'll likely exit the program, and 16% are neutral on their future commitment. The survey was part of the group's comment letter on a proposed rule to restructure the shared-savings program. All in all, the CMS received more than 400 comments before the Oct. 16 deadline.
The new attitude appears to stem from some proposed tweaks, including changing how patients will be assigned. The CMS has suggested giving ACOs a choice for beneficiary assignments. That flexibility would give ACOs more options and make the transition to a risk-based model a little easier, association CEO Clif Gaus said in a comment letter.
But ACOs are still worried about taking on financial risks. Under Obama-era regulations, ACOs that started in Track 1 in either 2012 or 2013 are supposed to move to a risk-based model by the third contract period, which begins next year. The CMS now wants first-time ACOs to have two years without financial penalties and they'd only receive 25% rather than 50% of their savings. ACOs that participated in the shared-savings program before will only get one year of upside-only risk.