Allison Brennan Outlines Concerns With a Faster Move to Risk for ACOs

Pushing accountable care organizations (ACOs) to take on risk faster will likely result in ACOs that aren’t ready just dropping out of the program and could impact participation in value-based care, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

Transcript

How do you think CMS pushing ACOs to take on more risk faster with the proposed Pathways to Success will impact participation?

We have some significant concerns about this approach. So, at the end of the day, this is a voluntary program. And if you’re option is take on risk that you’re not ready to assume or drop out of the program, I think we’re going to see ACOs drop out of the program.

And that’s very concerning for us. We’re very supportive of preparing ACOs to take on risk and encouraging ACOs to do so. Where we have concerns is the way in which it’s being done, the time frame in which it’s being done, and more of a stick approach rather than a carrot approach, where we’re making these 2-sided models so much more attractive that people feel that they want to be a part of them.

I think it’s really important to note that the experience ACOs gain in a 1-sided model is what allows them to go through their initial learning curve to prepare to take on risk, and then to, hopefully, show even greater results over time. So, if we’re discouraging new ACOs from joining the program and getting on that learning curve, I think we’re discouraging them from getting on the continuum of value-based care, which is moving generally in the direction of risk.