Medicare Shared Savings ACO Participation to Grow Slightly in 2022

More Medicare beneficiaries will get help from Medicare Shared Savings Program providers this year, but the number is still lower than in 2020, new data shows.

Nearly one in five Medicare enrollees will be treated by ACO Shared Savings Program providers this year, slightly more than in 2021 but lower than in 2020, the Centers for Medicare and Medicaid Services said in a statement. projections posted on Wednesday. These ACOs will reach 11 million people in 2022, up from 10.7 million in 2021 and 11.2 million in 2020, according to CMS. data.

CMS also announced that as of January 1, 66 new ACOs have joined the program, including 20 in the second or third terms of the agreement. According to the National Association of ACOs, another 40 of those listed as new were formerly in ACOs or are part of existing Multi-ACOs.

This year, 140 more ACOs signed an agreement for a different period, bringing the total to 483. Last year, 477 ACOs participated, compared to 517 in 2020.

More ACOs are also taking risk this year, with 59% in two-way risk tracks compared to 41% in 2021.

ACOs are made up of doctors, hospitals, and other providers who coordinate the care of Medicare recipients. Provider participation in the ACO is voluntary, and those who join may receive bonuses based on how much money they save on Medicare and quality scores.

As the largest alternative payment model in Medicare, the Shared Savings Program is part of a broader CMS strategy to move towards cost-based payment mechanisms. Last year, the Center for Medicare and Medicaid Innovation announced its goal of moving all Medicare beneficiaries to one of these mechanisms by 2030.

“CMS’s commitment to value-based care has never been stronger. As we continue to work towards our goal of increasing the number of people in care relationships with responsibility for the quality and total cost of care, we applaud this increase in ACO involvement and know we still have a lot of work to do.” Mina Seshamani, director of the Medical Assistance Center, said in a press release.

However, the National ACO Association is unhappy with the modest increase in the number of participating ACOs and insured beneficiaries. CMS did not accept new members in 2021 due to the COVID-19 pandemic, and some of the ACOs that CMS describes as new have actually just switched to a general savings program from the now-defunct next-generation ACO model, according to industry data. organization.

Participation in the General Savings Program has not rebounded from the “Path to Success” policy introduced in 2018, which pushed more ACOs into risky agreements.

“Today should not be celebrated, but instead should be a call to action for policy makers to correct this trend and consider incentives to encourage participation in a voluntary program that has repeatedly generated savings and provided high quality care,” National Association of ACOs President and General director Clif Gaus said in a press release.

CMS’ goal of engaging all Medicare beneficiaries in value-based care systems is commendable, but the agency needs more to encourage ACO participation, the trade group argues. According to the National Association, raising ACO’s overall savings rate, fixing problems with ACO benchmarks that make it difficult to achieve savings, giving organizations more time to move to risk, reducing the administrative burden, providing better data, and changing quality reporting requirements. AKO.

Separately, CMMI uses a direct contract model, which is based on the General Savings Program and the next generation ACO model. According to the National Association of ACOs, CMS has put applications on hold for 2022, but applicants who have delayed application start dates and former Next Gen applicants will still begin admission this year. CMMI has not yet announced the direct contract participants.

“NAACOS is waiting to see what it’s like to participate in a new direct contract model, another accountable aid model. Hopefully this will partly explain the lack of growth in the general savings program,” Gaus said.

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