Dr Rob Fields: Proposed MSSP Changes Likely to Stifle ACO Movement, Increase Consolidation

Systems, groups, and practices that haven’t yet joined the accountable care organization (ACO) movement will find it harder to do so if the proposed changes to the Medicare Shared Savings Program (MSSP) take effect, said Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System.

Transcript

How will the push to have MSSP ACOs take on more risk faster impact the program? Will it have an impact on the overall ACO movement?

I think it absolutely will. I am very concerned in particular about new systems that are considering joining the ACO movement. If we look, there has been steady growth in the ACO movement over the last several years, which is great, but we still only cover a minority of all Medicare beneficiaries.

We certainly hope that would change over time. But there is significant concern that for those systems and groups and practices have not yet joined the ACO movement, that they’ve been somewhat slow to adapting to the world of value, it is less likely, I think, that they would do that now, at least not in the same way. Because the potential upside versus the rather significant downside makes it really hard to make that financial decision. I think it would be really difficult to do so without some level of consolidation or movement or alignment in some more fundamental way with a bigger system. And, therefore, I think it’s actually going to lead to the very consolidation that we’re hoping to prevent, unfortunately.

I just don’t think individual practices or systems will have a choice if they haven’t already entered into the world of value.