AHA, others urge flexibility in Medicare ACO spending targets due to pandemic

A coalition of hospital and physician organizations, including the AHA, yesterday urged the Centers for Medicare & Medicaid Services to give Medicare accountable care organizations the option to use pre-pandemic spending benchmarks to set financial targets beginning in performance year 2022.

“By allowing an option to use earlier years to set MSSP benchmarks for certain ACOs, CMS will avoid the anomalies in utilization resulting from the COVID-19 pandemic. This provides a more credible baseline for certain ACOs disproportionately harmed by the pandemic,” the letter states. “Those such ACOs are currently evaluating whether to enter new five-year agreement periods. Having a longer agreement period means the effects of pandemic-stricken years will follow ACOs for a significant amount of time. This is particularly problematic as ACOs move to take on greater levels of risk.”