Recommendation for a population-based approach is part of annual MedPAC report to Congress
CMS could induce more providers to participate in alternative payment models (APMs) by adopting a population-based payment approach for APMs and thereby reduce the complexity and uncertainty providers face when deciding whether to participate in one.
That suggestion, included in MedPAC’s June 2022 report to Congress, is among several the commission made for implementing its earlier recommendation that CMS reduce the number of Medicare APMs and design the models to work better together.
By consolidating or eliminating some of the seven current tracks, the commission says, CMS could target them more precisely according to a provider organization’s size and ability to take on financial risk.
Other MedPAC recommendations for overhauling the APM program include:
MedPAC acknowledges that its recommendations would represent a shift from CMS’s current strategy of temporarily testing numerous model tracks on a small scale to permanently operating fewer tracks on a large scale, but believes the proposed changes offer “a promising avenue for lowering fee-for-service spending while preserving or improving care quality.”
In a statement responding to the recommendations, the National Association of Accountable Care Organizations said it is still reviewing the details, but is “pleased to see MedPAC devote such time and attention to improving Medicare’s ACO models” and “appreciates the fact MedPAC noted that allocating savings between models must be done in a way so incentives for the ACO to save and participate are considered if maximizing participation in a population-based payment model is a priority.”
Elsewhere in its report the commission:
As part of its mandate from Congress, each June MedPAC reports on issues affecting the Medicare program as well as broader changes in health care delivery and the market for health care services.