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NAACOS asks CMS to push back deadline for ACO applications
Source: Inside Health
The National Association of Accountable Care Organizations says CMS should give ACOs more time to apply to the revamped ACO program after the agency set a Feb. 19 deadline. NAACOS wants CMS to give ACOs until late March to decide whether to participate.
"Setting an application deadline two months after publishing the final rule does not give ACOs that have expiring agreements the necessary time to vet the decision internally or the time to process the many elements of the application,” said Jennifer Moore, an NAACOS board member and the chief operating officer at MaineHealth ACO. “Given the significant changes, ACOs need to engage actuaries to understand how we would fare in downside risk. Such an analysis takes time. Without that time, we would have to enter an upside track out of the gate.”
“After interpreting the effects of the changes, ACOs face several critical decisions"
CMS says the Notice of Intent to Apply to the program fora July 1 start date is due by Jan. 18, but that notice is non-binding. ACOs must notify CMS if they intend to apply for the new basic or enhanced track of the program, to apply for a nursing home three-day stay rule waiver and to establish a beneficiary incentive program.
The application period is from Jan. 22 through Feb. 19. The deadline applies to new ACOs, those with agreements that expired at the end of 2018, and ACOs that want to end their current agreement early to start in the new program. Those with three-year agreements that expire at the end of this year or in 2020 can finish their current contracts before starting the new program.
CMS finished the ACO program overhaul Dec. 21. That rule shortened the time that ACOs can participate without the risk of penalties for poor performance, and it lowered the shared savings rate for those one-sided ACOs from 50 percent to 40 percent -- an increase from the proposed 25 percent shared savings rate. NAACOS said it was grateful for the concessions CMS made in the final rule but says changes could lower participation rates and harm the program.
NAACOS says moretime is needed for ACOs to make participation decisions, as those decisions are complex.
“After interpreting the effects of the changes, ACOs face several critical decisions, including what groups of doctors and providers to include in their ACOs, signing agreements with those groups (which can number into the dozens), electing levels of risk or track participation, establishing repayment options, making choices about what waivers to apply for, among other choices,” NAACOS says in a press release.
The group adds that on top of that, the deadline to apply for CMS’ Bundled Payments for Care Improvement Advanced demonstration is March 1, and quality reporting for different Medicare programs takes place in January and February.
“ACOs barely have time to understand the new rules, and organizing an application is very complicated and for some it is now a high-risk decision,” said Clif Gaus, NAACOS president and CEO. “There are too many difficult decisions to rush.” -- Michelle M. Stein (mstein@iwpnews.com)
This article was written by Michelle M. Stein from InsideHealth and was legally licensed through the NewsCred publisher network. Please direct all licensing questions to legal@newscred.com.