Video

Dr Joe Antos: CMS' Proposed MSSP Changes Don't Account for Variability in Healthcare

The proposed CMS regulation to change the Medicare Shared Savings Program (MSSP) so that accountable care organizations (ACOs) take on risk faster creates a one-size-fits-all model that doesn’t allow for variability, said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

The proposed CMS regulation to change the Medicare Shared Savings Program (MSSP) so that accountable care organizations (ACOs) take on risk faster creates a one-size-fits-all model that doesn’t allow for variability, said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

Transcript

How do you think pushing more accountable care organizations (ACOs) to take on risk faster will impact participation in the MSSP?

I’m concerned about the new CMS regulation, because it’s not at all clear that giving ACOs 5 years, I believe it is, and you’re either successful or you’re out, necessarily makes sense. There’s a lot of variability in healthcare. That’s the problem. And there’s a lot of variability geographically, and a whole bunch of other factors are at work as well.

So, this one-size-fits-all—which, unfortunately, is pretty much the only way the government can set a rule—makes it difficult. I think, in the end, what people have predicted will probably come true, but it might be transitory. I think there will be ACOs who are now in the program who will drop out. There will be some discouragement factor there. Not as many organizations will try to become an ACO, until the kinks are worked out. I think that’s the issue. Because it’s not just “there’s a rule.” It’s, “well, how does CMS actually implement it and are there ways to deal with whatever the hard barriers are?” These are businesses—they’ll find ways.

Related Videos
Kimberly Westrich, MA, chief strategy officer at the National Pharmaceutical Council
Sam Peasah, PhD, MBA, RPh, director for the Center of High-Value Health Care at the University of Pittsburgh Medical Center
Jawad Haider Butt, MD, PhD
Laura Bobolts, PharmD, BCOP, senior vice president of clinical strategy and growth at OncoHealth
Barry Byrne, MD, PhD, Powell Gene Therapy Center at the University of Florida
JC Scott, CEO and president, PCMA
Caspian Oliai, MD, MS, a medical oncologist and hematologist and medical director of the UCLA Bone Marrow Transplantation Stem Cell Processing Center
Neha Kashalikar, PharmD, director of strategic pharmacy consulting, MassHealth
Adam Colburn, JD, vice president for congressional affairs, AMCP
Katrina Ortblad, ScD, MPH, Fred Hutch Cancer Center
Related Content
AJMC Managed Markets Network Logo
CH LogoCenter for Biosimilars Logo