Contributor: CMS Can Seize Opportunities to Fix the Rural Glitch, Risk Adjustment Caps in MSSP – AJMC.com Managed Markets Network

The Medicare Shared Savings Program (MSSP) has seen its growth slow, but CMS has an opportunity to act on proposals that would address benchmarking and more fairly allocate savings to accountable care organizations in the program.

In August, Administrator Chiquita Brooks-LaSure and other leaders from CMS shared their priorities for the next 10 years. In particular, they called out the importance of reducing inequities in health care, striving to get all Medicare and Medicaid beneficiaries in accountable care relationships, and designing financial incentives that will encourage participation in new payment and service delivery models.

Unfortunately, one of the programs with the most documented success for helping to achieve these aims, the Medicare Shared Savings Program (MSSP) or, more commonly, accountable care organizations (ACOs), has seen its growth slow partially as a result of regulatory changes that delayed one new applicant cycle, as well as the cancellation of another cycle due to the COVID-19 pandemic. If the new CMS leadership is looking for levers to pull to fulfill the goals it is setting related to reducing health disparities and promoting value-based care, then it needs to improve the operations and incentives of the MSSP, as well as address some unintended consequences of earlier policy decisions that have slowed its progress.

The good news is that CMS has an opportunity before it to act—by pushing forward with 2 provisions discussed in the proposed rule for the 2022 Medicare physician fee schedule that
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