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Survey: Many ACOs Will Leave Program if Required to Assume Risk

Posted in Accountable Care Organizations, Affordable Care Act, Home Healthcare, Hospitals and Institutions, Legislation and Public Policy, Medicare and Medicaid, Private Insurers, Reimbursement Matters

According to a recent survey by the National Association of Accountable Care Organizations (NAACOS), most of the ACOs that joined the Medicare Shared Savings Program (MSSP) in 2012 and 2013 in the non-risk bearing “Track 1” will leave the program if they are required to assume financial risk. Under the program’s current rules, these ACOs will be required to move to a two-sided (risk-bearing) model in their third agreement period that begins in 2019.Of the 82 ACOs surveyed, 25 of the 35 that responded said that they were not ready to assume risk. There were 561 ACOs participating in the MSSP as of January 2018, 460 (82%) of which were in Track 1. The 561 ACOs cover 10.5 million assigned Medicare beneficiaries.

NAACOS issued a press release announcing the survey results. In the release, the association’s President and CEO, Clif Gaus, expressed concern that unless the MSSP rules are changed, those ACOs that are unwilling to assume risk will “quit the program, divest their care coordination resources and return to payment models that emphasize volume over value. This would be a real setback for Medicare payment reform efforts.”

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