Accountable care organizations are claiming they don't have all the information needed to decide if they want to participate in the direct-contracting options from the Center for Medicare and Medicaid Innovation even though the deadline to apply for the implementation period is days away.
The application window to participate in the implementation period of the direct-contracting models closes Feb. 25, but in a letter to the Innovation Center, the National Association of ACOs claims specific information about benchmarking, risk adjustment and capitated payments haven't yet been released.
"Without these details, it's impossible for the healthcare community to make informed decisions about program participation," wrote Clif Gaus, CEO of the National Association of ACOs, in the letter.
The implementation period, which is when participants will "engage in beneficiary alignment and other activities," is a precursor to the first performance year, which will begin in 2021, according to the CMS. Applications for the first performance year will begin in spring 2020.
Gaus urged the Innovation Center to release this information as soon as possible. He added that without more information, the Medicare Shared Savings Program and other alternative payment models will be "more attraction and stable" options compared to direct contracting.
The CMS said it will respond to the letter from NAACOs.
The Innovation Center first announced its direct-contracting options last April. The models offer capitated payments for Medicare fee-for-service beneficiaries through full or partial downside risk.
The NAACOs letter also lists several changes the association would like to see made to the direct-contracting options, including increasing the shared savings rate for the partial risk-taking option from 50% to 75%.
Gaus said the model as it currently stands won't be attractive to providers because the enhanced track of the Medicare Shared Savings Program allows for up to 75% in shared savings.
"The Innovation Center should increase the shared savings rate... to 75% to make it an attractive option for those (participants) that are not ready for full risk," he added.
The model is slated to last for five years.
