A lot has happened in health care since 2012, when final rules permitted provider-organized ACOs to be the driving force of Value-Based Care under the 2010 Affordable Care Act (ACA). As we pass the ACA’s eleventh anniversary, a dwindling number of Medicare Shared Savings Program (MSSP) ACOs are entering a new phase marked by higher expectations and more difficult economics.
By all accounts, Covid-19 has amplified the discussion around critical health disparities and inequities that have plagued the United States and its most vulnerable patient populations for generations. The past year has exposed how disease does in fact discriminate, and that socioeconomic challenges exacerbate the symptoms of illness. As a result, the healthcare industry has accelerated its efforts in addressing the social determinants of health (SDOH) by introducing initiatives that specifically target these deficiencies.
Now that the Biden administration is putting a new team in charge of CMS, advocates for accountable care organizations (ACOs) are preparing to push for changes that they say will bolster CMS’ ACO programs and make risk sharing more palatable. The National Association of ACOs (NAACOS) says that ACOs have worked as intended to slow the rate of spending growth for the Medicare program.
A group of leading healthcare industry groups are calling on HHS to provide more full-risk accountable care organization (ACO) model options, including an extension of the popular Next Generation ACO Model. “We are writing to urge HHS to extend this model through 2022 and create a permanent full risk ACO option based on Next Gen for the future. We also ask that HHS reexamine the model evaluation reports,” the 14 groups wrote to HHS Secretary Xavier Becerra.
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