Policy Update: MSSP Growth, Health Care Value Week Recap, Policy Webinars

February 4, 2022

Medicare Shared Savings Program Grows with Lion’s Share of Growth Coming from Aledade
The Medicare Shared Savings Program covers 324,000 more Medicare beneficiaries in 2022 than it did in 2021. Aledade accounts for more than 200,000 of those people. There are 24 brand new ACOs and 40 ACOs came back into the program after leaving during the height of COVID-19 uncertainty. Combine this with a projected 70 – 100 Direct Contracting model entities and it was a good year for the ACO model despite CMS being in an information-gathering phase with the new Biden Administration. We look forward to action from CMS this year for even greater growth next year.
Value Week Dialogue Sets the Tone for Advocacy in 2022
Last week’s Health Care Value Week provided an opportunity for Aledade and our fellow travelers in value-based and accountable care to kick off 2022 with clear and consistent messaging around the ability for value-based care models to improve quality of care and patient experience, address health inequities, and lower costs. Throughout the week’s panel discussions and Congressional briefing, we focused on drilling into three primary messages to communicate to regulators and legislators:

  • Aledade’s Sean Cavanaugh discussed the need for CMS to continually refine CMMI models to encourage participation and success with Medicare Director Meena Seshamani to increase both participation and success in ACOs. 
  • Aledade’s Dr. Susan Huang advocated for Congress to have the right incentives in place to send a critical signal that the shift to value is inevitable. The most pressing is to the 5% Advanced Alternative Payment Model (AAPM) bonus to encourage more practices to join. 
  • Aledade’s co-founder and CEO, Dr. Farzad Mostashari emphasized just how the ACO model made it more profitable to prevent a stroke than to treat a stroke, we need to make achieving health equity the economically rational thing to do. 

We are grateful for the opportunity to participate in the dialogue with health care stakeholders, policymakers, and CMS leadership to set a clear roadmap for 2022. Value Week was a great way to start off the year, and we will continue to use our data and experiences to contribute to learnings and scaling up of value-based and physician-led accountable care.
Primary Care First Webinar
On February 10th Aledade will be hosting a webinar for Primary Care First practices to review key requirements and deadlines as well as go over how the work you’re already doing for the ACO aligns with the work you will need to do to be successful in PCF. Britainy Barnes, Senior Policy Analyst, will be joined by a Cohort 1 practice who will share their lessons learned and have a Q&A session at the end. Click here to register.
CMS Vaccine Mandates 
The courts have made a decision, and CMS’s vaccine mandate is now enforceable in all 50 states, DC, and the US territories. Employees subject to the mandate must be fully vaccinated by February 28, March 15, or March 21. The implementation timeline for each state can be found here. As a reminder, CMS’s vaccine mandate for health care staff does NOT apply to physician offices. The rule only applies to facilities that are subject to CMS health and safety regulations (aka Conditions of Participation) such as FQHCs, RHCs, laboratories, SNFs, and of course hospitals.
Workforce Shortages Webinar
Last month, we held a webinar on the primary care workforce shortage, including its causes and effects, as well as practical solutions from our partner ACO practices and policy recommendations to continue combatting this issue. Caroline Smith, Senior Policy Analyst, facilitated a discussion on creative opportunities for ACO practices and clinics to use value-based care initiatives to lift some of the burden the workforce is experiencing. Access the recording here.

Thank you for everything you are doing and please stay safe.