The Medicare Shared Savings Program (MSSP) represents the Medicare pro- gram’s flagship alternative payment model, and AMGA believes it offers
providers the opportunity to transition to
value-based care, provided the program’s regulations and incentives are properly designed.
Earlier this year, the Centers for Medicare &
Medicaid Services (CMS) proposed significant
reforms to the MSSP that underestimated the
difficulties providers face in shifting to risk-
based payment models such as Accountable
Care Organizations (ACOs). In response to the
proposed rule, AMGA offered detailed recom-
mendations on how CMS can improve the MSSP
so that it remains an attractive model that offers
AMGA members a realistic opportunity not only
to learn how to deliver care in a value-based
system, but to do so successfully. AMGA spe-
cifically offered recommendations to revise
CMS’ proposals for the timeframe to transition
to risk; on how to address flaws in the MSSP’s
benchmarking methodology; on the need
for appropriate risk-adjustment for an ACO’s
assigned beneficiaries; and on other aspects
of the program.
In the proposed rule, CMS reiterated its
concern that two-sided ACO models outperform those without downside financial risk, a
characterization that AMGA believes is faulty.
Balance incentives, risk in MSSP
By Darryl M.