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Payment Reform Expert Pans MSSP Track 1+

Analysis  |  By Christopher Cheney  
   January 09, 2017

Medicare's most popular ACO program is criticized for failing to save taxpayer dollars and perpetuating a fee-for-service approach to the financing of healthcare services.

A healthcare payment reform advocate is calling on Medicare officials to shift away from agency's biggest shared savings program and to foster more alternative payment models that generate value for patients and taxpayers.

Harold D. Miller, president and CEO at the Center for Healthcare Quality and Payment Reform, a non-profit, is lambasting the new Track 1+ in the Medicare Shared Savings Program and the Centers for Medicare & Medicaid Services.

"The CMS MSSP program has been a failure. CMS has lost money on the program for three straight years from 2013 to 2015, and the annual losses tripled from 2013 to 2015, totaling $216 million in 2015. CMS is losing money because nearly half—48%—of the accountable care organizations are increasing spending and the shared savings payments it makes to the ACOs that did save money wipe out any net savings it received," Miller says.

Give MSSP Track 1 Advanced APM Status, Researcher Urges

More healthcare providers participate in MSSP than any other ACO initiative that CMS has launched. Last year, 433 healthcare provider organizations participated in the program.

Until CMS rolls out MSSP Track 1+ in 2018, there are three tracks in the program, with varying levels of financial risk and shared-savings rates. MSSP Track 1 has no downside financial risk and the lowest shared-savings rate. MSSP Track 2 and Track 3 both have downside risk and higher shared-savings rates compared to Track 1.

Last month's announcement about the creation of Track 1+ highlights key elements of the new MSSP payment model, such as the opportunity for participating ACOs to qualify for Advanced Alternative Payment Model status under the Medicare Access and CHIP Reauthorization Act (MACRA).

"The new Medicare ACO Track 1+ Model will test a payment model that incorporates more limited downside risk than is currently present in Tracks 2 or 3 of the Medicare Shared Savings Program in order to encourage more rapid progression to performance-based risk," CMS officials said in last month's announcement.

CMS is 'On the Wrong Track'
In doubling down on MSSP, CMS is on the wrong track in promoting value-based care, Miller says.


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Christopher Cheney is the senior clinical care​ editor at HealthLeaders.

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