From Dr. Tom's Desk
CMS is proposing changing the rules in the Medicare Shared Saving Program (MSSP) for Accountable Care Organizations to accelerate the march towards accepting “downside risk.”
That’s right, under the new rules, ACOs will be encouraged to participate in MSSPs that put them on the hook for losses as well as gains.
The MSSP is the most popular of all the ACO programs, so that’s the one being targeted for acceleration into risk.
It’s the most popular because it generates the greatest potential profit with the least risk. Risk assumption will change that calculus. Given the lack of cost control tools that MSSPs provide ACOs and their physicians, taking on such a program would be foolish in the extreme.
Especially when there is much a much better system, with much better tools, under Medicare Advantage.
Simply beating doctors over the head with the fear of loss won’t translate into cost savings; it will translate into an exodus from MSSPs.
This is either poorly thought out policy or it’s part of the ongoing effort we’ve been discussing in these pages to transition chronically ill patients onto Medicare Advantage plans.
Either way, just say no.