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Many Significant COA Changes Included in Proposed Medicare Rule

The President and CEO of the National Association of ACOs (NAACOS), Clif Gaus, Sc.D., today released the following statement on the fee schedule proposed by the Centers for Medicare & Medicaid Services for 2023:

July 7, 2022 – “NAACOS sends a big shout out to the Centers for Medicare and Medicaid Services (CMS) for taking action toward its goal of creating a stronger Medicare by strengthening responsible models of care and accelerating the movement toward value for all patients.While we are still considering major changes, the Physician Fee Schedule policies proposed today will help increase participation in Accountable Care Organizations (ACOs), helping to realize the recent strategy refresh. of the CMS Innovation Center to connect every Medicare beneficiary with a provider accountable for their quality and total cost of care by 2030.

“Importantly, the changes proposed today by the CMS Projects would save Medicare more than $15 billion and yield $650 million in higher shared savings payments to ACOs. We know that the most effective Alternative Payment Models (APMs) are those where providers are held accountable for patient outcomes year-round, as ACOs do. »

Among the positive changes proposed today, CMS proposed to:

  • Give ACOs more time before moving to higher risk levels;
  • Establish fairer and more accurate financial benchmarks for ACOs by incorporating a forward-looking administrative growth factor;
  • Add health equity quality adjustment for high quality performance in OCAs with severely underserved populations;
  • Provide shared savings advance payments to small ACOs that serve underserved populations;
  • Consider an ACO’s past savings in rebased benchmarks to help mitigate the decline of an ACO’s benchmark over time; and
  • Make positive changes to quality scoring approaches.

“NAACOS thanks both the Biden administration and the ACO Congressional Champions for their leadership on today’s rule changes. We will continue to work closely with CMS and Congress on additional necessary changes such as the extension of the 5% Advanced APM Bonus, which expires this fall.

About NAACOS. The National Association of ACOs (NAACOS) represents more than 13 million beneficiary lives through hundreds of organizations participating in population health-focused payment and delivery models in Medicare, Medicaid and commercial insurance . Models include the Medicare Shared Savings Program (MSSP), Global and Occupational Direct Contracts, ACO REACH, and alternative payment models supported by a myriad of commercial health plans and Medicare Advantage. NAACOS is a member-directed and owned not-for-profit organization that strives to improve the quality of care, outcomes and cost-effectiveness of healthcare.

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