As the coronavirus has dramatically altered your sales team’s plans for 2020, it also has affected plans for your customers, including accountable care organizations (ACOs). The Centers for Medicare and Medicaid Services (CMS) announced this summer that ACOs would get a bit of a reprieve as providers face declining revenue from fewer elective procedures and higher expenses from managing COVID-19 patient care.
These changes relate to CMS’s glide path within the “Pathways to Success” program, unveiled in 2018 to encourage providers to transition to two-sided risk models. Although CMS had hoped to move more Medicare ACOs to two-sided models next year, it is allowing these ACOs (which would normally be required to increase their financial risk) to maintain their current risk level for 2021. This means they will not automatically advance to the next risk level on the glide path.
CMS also changed how it measures losses for Medicare ACOs (and providers in other value-based payment models) during the public health crisis. Additionally, CMS has pushed back the start dates for some of its newer value-based models (like the Direct Contracting and Primary Care First Models) that your customers might be planning to enter down the road.