NAACOS Leaders Document Major MSSP Savings, Support Pro-ACO Legislation in Congress
On Wednesday, Aug 25, leaders at the Washington, D.C.-based NAACOS—the National Association of ACOs—trumpeted the progress of accountable care organizations in saving money for the Medicare program, one day after joining eleven fellow national healthcare associations in pleading with members of Congress to include legislation supporting alternative payment model acceleration in upcoming federal legislation.
On Wednesday, NAACOS leaders boasted of the value that has been documented by ACOs participating in the Medicare Shared Savings Program (MSSP). They posted on the association’s website a press release that began thus: “Medicare’s largest alternative payment model produced its highest annual savings to date in 2020, while continuing to provide high-quality care, as shown by performance data released today by the Centers for Medicare & Medicaid Services (CMS). The Medicare Shared Savings Program, the accountable care organization (ACO) model that served 10.6 million seniors in 2020, collectively saved Medicare $4.1 billion last year, and $1.9 billion after accounting for shared savings payments. Importantly, these ACOs also hit an average quality score of 97.8 percent and 60 ACOs earned a perfect score of 100. This is an improvement over the $2.6 billion and $1.2 billion in gross and net savings MSSP created in 2019, making 2020 the best year yet for ACOs,” NAACOS noted.
“Today’s data underscores the need for policymakers to do all they can to grow the ACO model and extend the program’s benefits to more patients,” Clif Gaus, Sc.D., NAACOS’s president and CEO, said in a statement contained in the press release. “We currently have the fewest number of Shared Savings Program ACOs since 2017. That trend must be reversed, given continued debate about ways to improve our health system.”
What’s more, the press release noted that “NAACOS attributes the drop in ACOs to several Trump-era policies, including 2018 changes CMS called ‘Pathways to Success,’ which gave ACOs limited time before taking on financial risk and cut the share of savings most ACOs are eligible to keep. NAACOS supports the Value in Health Care Act (H.R. 4587), which would increase shared savings rates, create favorable risk adjustment and benchmarking policies, and provide at least three years before being forced to take on risk. We and other leading healthcare organizations are pushing Congress to include the Value Act in the upcoming reconciliation bill.”
And the association noted the following statistics regarding MSSP ACOs’ performance in calendar year 2020:
Ø $390 in gross savings per beneficiary
Ø 345 out of 513, or 67 percent, of ACOs earned shared savings
Ø ACOs earned $2.3 billion in shared savings payments
Ø 75 percent of shared savings-only ACOs produced gross savings and 55 percent earned shared savings
Ø 97 percent of at-risk ACOS produced gross savings and 88 percent earned shared savings
“During the pandemic-stricken year of 2020, ACOs were valuable assets in managing patient care, NAACOS noted. “Given their accountability to long-term patient care and outcomes, ACOs were proactive in their outreach to high-risk patients to keep them healthy, quickly established telehealth and remote monitoring capabilities to continue to provide care, and effectively managed home visits and post-acute care to reduce COVID transmission.”
Meanwhile, just the day before, on Tuesday, Aug. 24, NAACOS had posted to its website a press release noting that “Twelve leading healthcare organizations are asking Congress to include a bipartisan House bill that will accelerate Medicare’s move to value-based payment in the upcoming reconciliation bill. In a letter sent today to Senate Finance Committee Chair Ron Wyden and House Ways and Means Committee Chair Richard Neal, the groups point to a recent, independent analysis by the Moran Company that shows the Value in Health Care Act (H.R. 4587) would save $280 million over 10 years.”
“As lawmakers look for offsets or ways to fund the estimated $3.5 trillion new spending in the reconciliation bill, the Value Act provides an avenue to both lower Medicare spending and advance policy to improve our fragmented health system,” Clif Gaus, Sc.D., said in a statement included in the press release.
As the press release noted, “NAACOS commissioned the analysis in which the Moran Company used statistical modeling to replicate how the Congressional Budget Office (CBO) might ‘score’ the Value in Health Care Act. The analysis found the legislation could increase participation in ACOs, which have shown to lower Medicare spending, thereby creating more financial savings for Medicare.”
“If the Act is successful in expanding provider participation in ACOs, some of the shortfall between the current savings that have been achieved by ACOs and CBO’s prior projections could be realized—providing savings that could exceed the cost of increasing shared savings payment rates and other provisions of the Act that serve to increase payments to ACOs,” the Moran Company’s report stated.
“The bill, called the Value Act for short, strengthens the Medicare Shared Savings Program by updating the program to recognize and reward ACOs. Specifically, the bill increases shared savings rates, updates risk adjustment rules, eliminates the artificial distinction between “high” and “low” revenue ACOs, addresses ACOs’ “rural glitch,” and restarts the ACO Investment Model. The bill also reinforces the shift to value-based care by extending the 5 percent Advanced Alternate Payment Model (APM) incentive payments for an additional six years and authorizing a study of the overlap of various Medicare APMs. The bill lastly mandates a report by the Government Accountability Office on health outcomes and racial disparities in Medicare patients cared for by ACO participants compared to traditional Medicare and Medicare Advantage. The Value Act was introduced last month by Reps. Peter Welch (D-Vt.), Suzan DelBene (D-Wash.), Darin LaHood (R-Ill.), and Brad Wenstrup (R-Ohio). Fourteen national health stakeholder groups have pledged their support of the bill,” the press release noted.
The letter was signed by American Academy of Family Physicians, America College of Physicians, American Hospital Association, American Medical Association, AMGA, America's Physician Groups, Association of American Medical Colleges, Federation of American Hospitals, Health Care Transformation Task Force, Medical Group Management Association, NAACOS, and Premier healthcare alliance.
Industry observers have noted that, with the budget reconciliation process moving forward in Congress, members of Congress will be seeking out budget offsets, and that alternative payment mechanisms under Medicare might potentially appeal to legislators.
