Give MSSP Track 1 Advanced APM Status, Researcher Urges

Christopher Cheney, October 17, 2016

The most popular track of Medicare's largest accountable care organization program should be included under MACRA, the just-finalized payment system for physicians, a healthcare policy researcher says.

J. Michael McWilliams, MD, PhD
J. Michael McWilliams, MD

Net savings generated through the Medicare Shared Savings Program in 2014 were understated by at least $398 million, a researcher at the Harvard Medical School Department of Health Care Policy says.

"It is a pretty good guess and certainly not a wild overestimate," J. Michael McWilliams, MD, PhD, told HealthLeaders last week. He penned an opinion piece which was published last week in the Annals of Internal Medicine.

Launched in 2012, MSSP has drawn more healthcare provider participation than any other ACO program created by the Centers for Medicare & Medicaid Services. This year, 434 ACOs are participating in the payment program, providing care to more than 7.7 million Medicare beneficiaries, according to CMS.

On an annual basis, CMS sets a total spending benchmark for each MSSP ACO's attributed patient population. An ACO can earn a shared-saving bonus payment from CMS if total spending is significantly below the organization's benchmark. The bonus payments are reduced if an MSSP ACO falls short on the program's three dozen quality measures.

For 2014, MSSP generated $287 million in net savings for Medicare, according to a research paper McWilliams published last month in the Journal of the American Medical Association.

Christopher Cheney

Christopher Cheney is the senior finance editor at HealthLeaders Media.

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