News: Groups urge CMS to use pre-pandemic years for 2022 ACO benchmarks

CDI Strategies - Volume 16, Issue 5

The National Association of Accountable Care Organizations (NAACOS) has asked CMS to allow accountable care organizations (ACOs) the option to use pre-pandemic years when setting Medicare Shared Savings Program (MSSP) benchmarks for 2022. Currently, ACOs renewing or receiving new agreements that enter the MSSP in 2022 will receive benchmarks from CMS based on spending targets from the years 2019 through 2021.

Because of unusual spending fluctuation between 2019 and 2021 due to the COVID-19 pandemic, benchmarks for 2022 based on these years would be unfair to ACOs, the group stated.

“Some parts of the country were devastated in 2020 yet have not resumed more in-office preventative visits and elective procedures. For other areas, it was the opposite with 2020 providing little change in utilization from previous years, and doctors and hospitals now being hit hard by the pandemic this year,” the NAACOS letter to CMS states.

Though overall ACOs saw success in 2020, some saw losses due to the CMS benchmarking policy of using a blended national-regional adjustment to decide final benchmarks. Medicare spending decreased nationally nearly 7% in 2020, hurting ACOs that did not experience a reduction during the pandemic.

“If this administration is serious about getting all patients into a clinical relationship with providers accountable for their outcomes, they need to create a fair, level playing field for how ACOs are held accountable,” the letter states.

Editor’s note: The NAACOS letter to CMS can be found here.

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