The Centers for Medicare and Medicaid Services (CMS) released a proposed rule to strengthen the performance measurements for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program.
The proposed rule aims to improve long-term incentives for ACOs, with the ultimate goal of increasing the number of ACOs nationwide. “This should have the effect of growing the number of ACOs, and making ACOs and the coordinated care they provide to patients, more of a standard in all parts of the country,” said CMS Acting Administrator Andy Slavitt in a Jan. 28 release.
CMS developed the suggested changes after reviewing extensive stakeholder input. The proposed rule would modify the process for resetting performance benchmarks in order to account for regional differences. Key elements of the proposed rule include:
- Adoption of regional, rather than national spending growth trends, when establishing and updating an ACO’s rebased benchmarks
- Period adjustments of benchmarks based on the comparison of fee-for-service spending in the ACO’s regional service area and the ACO’s historical spending, which will provide a greater incentive for continued ACO participation and improvement.
- Giving ACOs time to prepare for benchmarks that incorporate regional expenditures by using a phased-in approach to implementation.
The proposed rule has been published on the Federal Register. Public comments will be accepted now through March 28, 2016.
CMS also provides a fact sheet with more details on the proposed changes.
What does this mean for physicians?
The proposed rule, with CMS’ goal of growing the number of ACOs, is one more sign that the transition from volume to value is coming, and faster than many anticipated.
For more information on ACOs and other emerging payment models, members can access:
- The online publication “Life after Fee-for-Service: A Physician’s Guide to Success in Emerging Budget-Based Payment Options.”
- A web page with examples of the transition to value-based care, including quality incentives that are part of the 2016 Medicare physician fee schedule.
How can you prepare for the transition that will take the learning of new skills sets to be successful? PAMED’s innovative CME series of six online, on-demand modules, free to PAMED members, can help.
The courses cover important topics, including practical health informatics, using the data toolbox in your practice, quality management, process improvement, lessons learned from the managed care era, and population health. You can earn up to 1 credit of CME for each online course.