Spotlight on ACOs

The National Association of Accountable Care Organizations (NAACOS) called on CMS to pay close attention to what it sees as a dip in the number of new ACO participants for 2019 and lays out recommendations that could help entice new organizations to join the program.

CMS cancelled the Medicare Advantage Qualifying Payment Arrangement Incentive Demonstration due to low participation rates, and some physicians may have opted not to participate partly because there was no ability to access bonuses from the Merit-based Incentive Payment System or the alternative pay models, according to the American Medical Group Association (AMGA).

Medicare Advantage plans and some Medicare advocates are asking CMS to work with plans on a framework to sustainably implement supplemental benefits for the chronically ill in 2020, coming as the Bipartisan Policy Center calls for Congress to follow MA’s lead and also authorize non-medical benefits for Medicare fee-for-service beneficiaries with chronic illnesses.

CMS agreed on Wednesday (July 10) to turn a tobacco-use quality measure into a pay-for-reporting measure rather than a pay-for-performance measure in 2018 in response to concerns by the National Association of Accountable Care Organizations (NAACOS).

CMS on Wednesday (July 10) proposed a long-awaited bundled pay model for radiation oncology that would replace Medicare’s fee-for-service payments in certain geographic areas.

The White House Office of Management and Budget on June 5 began reviewing highly anticipated changes to the Stark, or physician self-referral, law.

Avalere says about half of providers in the voluntary Oncology Care Model could end up owing CMS money if they join a two-sided risk model with less downside than CMS’ initial offering -- the initial two-sided risk option included in the OCM could lead more than 70% of participants to owe money, according to Avalere’s analysis.

As lawmakers framed the watermark 2015 law that revamped how Medicare pays doctors as a step in the right direction, physician groups bombarded Senate Finance Committee members on Wednesday (May 8) with suggestions on ways to improve the law, including continuing base pay hikes for physicians over the next few years, making the 5% bonus for those participating in alternative pay models permanent and, according to one academic, eliminating the Merit-based Incentive Payment System completely.

CMS says it has an audit strategy in place for the Merit-based Inceptive Payment System, and will conduct audits and data validation this year on providers’ MIPS submissions of 2017 data, coming as the agency continues efforts to recoup incentive funds from the meaningful use of electronic health records program.