WASHINGTON — Physicians, hospitals, medical group practices and other stakeholders are joining together today to call on the Centers for Medicare and Medicaid Services (CMS) to further improve the Medicare Shared Savings Program (MSSP) and make it more sustainable.

The National Association of ACOs and Premier Healthcare Alliance convened a group including the American Medical Association (AMA) and other health care leaders representing the majority of Accountable Care Organizations (ACOs) participating in MSSP to send joint recommendations to CMS to ensure continued and increased participation in the ACO program to advance delivery system reform, improve the quality of patient care and reduce health care costs.

"The AMA supports innovations that will enhance the way we deliver care to patients and is pleased to be working together with leaders from across the health care ecosystem to provide the Administration with solutions that support existing ACOs and encourage others to join new models," said AMA President Robert M. Wah, MD. "The future of the ACO program is important to the future of Medicare and the health system as a whole. In just three years, physician-led ACOs have made a major impact on improving care coordination and quality while also reducing costs and that could just be the tip of the iceberg."

According to CMS, more than 7.8 million patients across the country receive care from physicians who are participating in an ACO. In fact, in just three years, there are already half as many patients engaged with ACOs as are enrolled in Medicare private plans, which have existed much longer. Medicare ACOs have generated more than $705 million in savings. Yet even though more than half of the ACOs participating in MSSP generated significant savings within the first year; only 25 percent were able to begin recouping the money they invested in transitioning to a new delivery model.

The recommendations made by the groups today aim to achieve a better balance between the risks and burdens the program places on ACOs and the opportunity to earn shared savings. The recent CMS proposal is a major step forward and adoption of the joint recommendations would build on ACOs' success, making the program more sustainable for the long term and allowing more physicians to participate.

"We want ACOs to have choices about how patients will be assigned, the degree of savings for which they will be held accountable and how to best coordinate patient care," said Dr. Wah. "While we appreciate CMS' efforts to be responsive to our prior feedback, the program needs the kinds of substantive changes recommended today by our collective organizations in order for ACOs to live up to their potential to transform health care delivery."

The groups recommend that CMS:

• Provide options that will allow ACOs to have more predictability in their patient populations and budgets;
• Offer an array of financial accountability options to ACOs related to minimum savings thresholds, shared savings and loss percentages and alternative payment models;
• Provide flexibility for specialist physicians who want to participate in more than one ACO and allow physicians to choose on an individual basis whether or not to have their primary care services included in ACO patient assignments;
• Allow waivers from certain Medicare policies to eliminate barriers to care coordination;
• Provide better and more timely data; and,
• Reward ACOs for quality performance and improvement.

The AMA is committed to improving health outcomes and enhancing professional satisfaction and practice sustainability and has developed resources for physicians interested in transitioning to new models of care delivery such as ACOs. For more information, click here.