Providers complain to feds about ACO structure, want more incentives

A new rule proposing sweeping changes to the Medicare accountable care model offers few incentives and could dissuade greater participation, 34 leading healthcare organizations and industry groups said Friday in a joint letter to the Centers for Medicare & Medicaid Services.

CMS proposes to change the Medicare Shared Savings Program (MSSP) by placing greater emphasis on primary care and promoting performance-based risk arrangements on transitions from one care setting to another.

But providers hit the plan hard last week, urging CMS to establish a more appropriate balance between risk and reward; to adopt payment waivers to eliminate barriers to care coordination; to modify the current benchmarking methodology; to provide better and timelier data; and to strengthen the assignment of Medicare beneficiaries, according to a published report.

In its Feb. 5 letter to CMS, the American Hospital Association said the plan applies “too many sticks and offers too few carrots” to participating providers.

Providers have asked CMS to revise its MSSP plans to provide greater savings opportunities and fewer financial risks, according to a Bloomberg News report.

Long-term care providers have welcomed pay-for-quality initiatives, but fear being so dependent on government funding will make them extremely vulnerable. The president's 2016 federal budget, which proposes to take away about $400 billion over the next 10 years from Medicare, Medicaid and other programs, would also impose a single bundled payment for many post-acute care services provided by long-term care facilities, and continue to incentivize nursing homes and home health agencies to deliver care more efficiently through the accountable care organization model.