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Analysis

Stakeholders Urge CMS to Drop Proposed ACO Quality Changes

By John Commins  
   September 23, 2020

Providers also complain that the delayed release of the final rule cuts into the time ACOs and other APMs would have to implement the changes.

Citing concerns about mandating sweeping new reporting requirements in the middle of a pandemic, some of the nation's largest physician and hospital associations on Wednesday asked the federal government to drop changes on how Medicare accountable care organizations are assessed for quality.

"The ACO quality changes proposed are significant and come at a time when ACOs are continuing to deal with challenges and uncertainty caused by the COVID-19 pandemic," the American Medical Association, and nine other stakeholder groups wrote in a joint letter to Centers for Medicare & Medicaid Services Administrator Seema Verma.

"Just as CMS has proposed to delay moving forward with the MIPS Value Pathways approach due to concerns with COVID-19, CMS should also postpone such a drastic and significant change to the way ACO quality is measured, assessed, reported and scored for purposes of both the MSSP and MIPS programs," the letter said.

"The proposed rule, set to take effect in 20201, mandates of how ACOs and other alternative payment models are assessed on quality in the Medicare Shared Savings Program and Merit-Based Incentive Payment System.

The stakeholders also complain that the delayed release of the final rule cuts into the time ACOs and other APMs would have to implement the changes.

Specifically, the stakeholders urged Verma to reconsider:

  • Ending the use of the Web Interface reporting mechanism, which has been used since the MSSP's inception.
     
  • Removing the pay-for-reporting year currently provided to ACOs beginning an initial MSSP contract as well as individual measures that are newly introduced to the measure set.
     
  • Changes to the quality measure set ACOs must report under the APM Performance Pathway.
     
  • Replacing the existing MIPS APM Scoring Standard, which the stakeholders claim "allows each APM to have its own set of unique quality measures and scoring approaches that best fit the particular model."

The letter was signed by the AMA, American College of Physicians, America's Essential Hospitals, America's Physician Groups, AMGA, Association of American Medical Colleges, Federation of American Hospitals, Medical Group Management Association, National Association of ACOs, and Premier.

“The ACO quality changes proposed are significant and come at a time when ACOs are continuing to deal with challenges and uncertainty caused by the COVID-19 pandemic.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

Specifically, the stakeholders urged Verma to reconsider:

Ending the use of the Web Interface reporting mechanism, which has been used since the MSSP's inception.

Removing the pay-for-reporting year currently provided to ACOs beginning an initial MSSP contract as well as individual measures that are newly introduced to the measure set.

Changes to the quality measure set ACOs must report under the APM Performance Pathway.

Replacing the existing MIPS APM Scoring Standard, which the stakeholders claim "allows each APM to have its own set of unique quality measures and scoring approaches that best fit the particular model."


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