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More ACOs Than Ever: Medicare Shared Savings Program Swells in 2018

News  |  By Steven Porter  
   January 19, 2018

“On behalf of the independents,” Whisman says, “there was a lot of angst because there was a lot of reporting that had to go into MIPS if they were doing it on their own: how they were going to get their data out of their systems or out of their patient charts, certainly the risk of losing money and losing payments if they weren’t on an electronic record already, and then also being compared across practices to large groups, such as employed groups that had the economies of scale that smaller practices didn’t have.”

Related: Cleveland Clinic ACO Targets ‘Big Buckets’ for Big Savings

With the MSSP ACO model, physician offices are empowered to learn from each other, says Shannon L. Ginther, JD, OhioHealth Venture’s chief operating officer.

“These doctors are every day seeing patients, seeing patients, trying to keep the doors open. So the idea of participating with another group they can learn from and access some resources, I think, is part of it as well,” Ginther says.

Incentivizing risk with bonus payments

Avalere Health, based in Washington, D.C., released updated research on the financial benefits of a new hybrid risk model made available to MSSP ACOs this year: Track 1+.

By analyzing data from performance year 2016, Avalere reached the conclusion that participants would benefit from taking on a limited amount of financial risk under the model, which would make them eligible to qualify for 5% bonus payments currently offered under the Quality Payment Program (QPP) to Advanced APMs.

“As they take on more risk, Medicare beneficiaries should see their providers doing more to keep their patients healthy,” said Avalere Senior Vice President Josh Seidman, in a statement.

Regardless of its potential benefits, only 10% of MSSP ACOs are taking part in the Track 1+ model this year. The non-risk based Track 1 model remains the most popular, with 82% of ACOs participating.

Yvonne Ketchum-Ward, CEO of Boise-based Community Health Center Network of Idaho, oversees one of those non-risk based Track 1 ACOs.

Her program serves federally qualified health centers that treat populations with a high rate of uninsured patients—all of whom receive care, regardless of their ability to pay. The real benefit of MSSP is in its reliable data, informational websites, and personnel who walk participants through their expectations, she says.

“There’s a lot of infrastructure that you have to have in place to go into these arrangements, and the payment doesn’t come until a year-and-a-half after you do the lift. So you do the work with the potential that a payment will come a year-and-a-half from now,” Ketchum-Ward says. “If the motivation is purely financial, you’re not going to be successful.”

Participant data for the much-smaller Next Generation ACO Model, which builds upon MSSP, were released Thursday. It, too, showed an increase in participants, moving from 45 ACOs in 2017 to 58 this year.

Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.

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