Could Two-Sided MSSP Risk the Accountability of Healthcare?

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According to a recent survey by the National Association of ACOs, the risks associated with the upcoming Medicare contracts have many people worried. As an increasing number of Medicare patients are being serviced by accountable care organizations, 46% of ACOs say it’s very unlikely that they’ll accept a “two-sided risk” in the next Medicare Shared Savings Plan (MSSP) contracts. Only 33% of ACOs said it was somewhat or very likely that they would accept the MSSP contracts.

The MSSP contracts that ACOs signed in 2012 were meant to last for three years with no risk for possible losses. However, the second set of contracts demands that ACOs share their losses with Medicare. These requirements, called the “two-sided risk” model, aren’t easy to accept. Providers are still struggling to convert from fee-for-service to value-based models. A smooth transition to this two-sided risk model needs to be made available before providers are willing to leave fee-for-service.

According to a recent report by the consulting firm Oliver Wyman, 15-17% or roughly 46 to 52 million of the American population is served by accountable care organizations. While ACOs are still rather limited in number, healthcare providers are continuing to join them at a rapid rate.

About 10% of total Medicare beneficiaries will now receive their healthcare from ACOs. Medicare ACOs currently serve about 33 million non-Medicare patients while non-Medicare ACOs serve up to 16 million people. These non-Medicare ACOs account for about 154 of the 520 ACOs currently in the United States.

Because 67% of the population now has access to an ACO, their impact will continue to grow. More accountable healthcare is the key to improving quality, reducing costs and building a system that will remain financially stable.

Author: Lauren Daniels