Despite many predictions in 2010 that the Medicare Shared Savings Program would fizzle out, value-based payments are here to stay — at least if the comments on CMS' proposed rule to update the program are any indication of interest.
"The detail and substance of the comments gives additional credence to the belief that value-based payments are here to stay and will eventually affect everyone in health care to at least some degree," reads an analysis from Leavitt Partners, a healthcare advising firm.
Leavitt Partners analyzed the 257 available comments posted by the Federal Government Regulations website to measure the attention given to the proposed rule, and get a pulse on its importance in the healthcare sector.
According to the analysis and an initial review of the comment letters, even large provider organizations like the American Hospital Association and the American Medical Association indicate "there is a sense that programs like the MSSP will eventually cease to be voluntary and will have a direct effect on all their members."
Here is how the analysis mapped out interest in the accountable care organization program.
- Almost half (40 percent) of commenters were ACOs or ACO enablers, which include groups that help establish ACOs, such as Aledade, Collaborative Health Systems and Accountable Care Associates.
- Of the ACO commenters, 63 percent were closely tied to a hospital and 37 percent were physician-only ACOs. This may be because hospitals have more staff available to submit comments, according to Leavitt Partners.
- More than one-fourth (28 percent) of commenters were non-ACO providers.
- Non-ACO providers were broken down by specialty physicians (33 percent), post-acute care (20 percent), hospitals (12 percent), physicians (8 percent), nurses (6 percent), primary care specific providers (5 percent) and other providers (16 percent).
- Commenters from think tanks represented 16 percent of respondents.
- 6 percent of commenters were in HIT.
- 3 percent of commenters were payers, however, the most active payers in accountable care agreements — Aetna, Cigna, UnitedHealthGroup and Anthem — all commented.
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