CMS proposes changing ACO benchmarks

The CMS wants to change how it evaluates whether the Medicare Shared Savings Program’s accountable care organizations save money.

The agency proposes moving away from assessing ACO benchmarks based on historical spending. It instead would analyze trends in regional fee-for-service costs.

“Medicare payments are an important catalyst to improving care delivery, spending our resources smarter and keeping people healthy,” said Andy Slavitt, acting CMS administrator, adding that the proposal would allow ACOs in all parts of the country to recognize “both their achievements and improvements.” Slavitt said he hopes the proposed changes will lead to more ACOs and help boost their model of coordinated care.

The proposed evaluation changes would save $120 million between 2017 and 2019, according to the CMS.

Benchmarking has been a sore spot for ACOs, some of which say the current methodology effectively punishes high-performing organizations, according to April Wortham Collins, manager of customer segment analysis for Decision Resources Group, a healthcare consultancy.

ACOs say they haven’t been able to share in savings, or if they do, the payouts are small. They say that under the current methodology, health systems with high baseline costs have a lot of room for improvement, while those with low baseline costs don’t. Comments on the proposal are due April 3.

“Medicare payments are an important catalyst to improving care delivery, spending our resources smarter and keeping people healthy.”

—Andy Slavitt Acting CMS administrator