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CMS proposing overhaul of Medicare accountable care organization rules


Attempts to steer more physicians into ACOs are part of the plan

CMS is looking to overhaul the Medicare accountable care organization program in hopes of improving equity. The plan would boost efforts to get more physicians into ACOs plus increase the number of doctors in rural area.

The reforms for ACOs in the Medicare Shared Savings Program would allow more time for organizations to move to performance-based risk and new quality reporting that includes measures for social determinants and adjustments for health equity.

According to CMS, the overhaul would yield $650 million in increased shared savings payments to ACOs, something the National Association of Accountable Care Organizations applauded.

The changes are part of the proposed 2023 physician fee schedule, which while boosting ACOs in one area, potentially hurts physicians in others. For example, the conversion factor is decreasing from $34.61 to $33.08.

In a time of staffing shortages, inflation, and persistent COVID, physician groups warn the decrease could drastically limit physician access for Medicare patients.

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