NAACOS Policy Session Recaps Changes Wrought by COVID-19 and Looks Ahead

Due to the chaos created by the spread of coronavirus disease 2019 (COVID-19), most of Congress’ time this year has been taken up by relief legislation, and the upcoming election season will leave little time to advocate for other measures of interest to accountable care organizations (ACOs), said officials of the National Association of ACOs (NAACOS) at their annual spring meeting Wednesday.

In a virtual session providing policy updates, Allison Brennan, MPP, senior vice president of government affairs for the organization, said it is still very much interested in seeking relief for rural ACOs through S 2648, the Rural ACO Improvement Act. The bill amends title XVIII of the Social Security Act to change the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location.

The president has signed 4 stimulus bills totaling $3 trillion in spending aimed at providing assistance to health care providers, hospitals, and systems, as well as new flexibilities around telehealth and substance use disorder (SUD).

Brennan noted that the Coronavirus Aid, Relief, and Economic Security Act included changes to federal law governing confidentiality of SUD records to ease the ability of health care providers to share, with patient consent, protected information specific to SUD. That has been a priority of NAACOS, she said.

In addition, Brennan said the organization was pleased by an “inaction”—NAACOS did not want CMS to accept a recommendation from the Medicare Payment Advisory Commission (MedPAC) that ACOs not attempt to reconcile spending and benchmarks for performance in 2020, given the COVID-19 operating environment. The organization wanted to retain the ability for ACOs that will manage to achieve shared savings to keep them, while protecting ACOs facing losses, she said.

However, CMS, through its Center for Medicare and Medicaid Innovation, delayed the start of its direct contracting model, which was another MedPAC request.

Despite the pandemic and its complications, Brennan said the shift to value-based care will continue.

Jennifer Gasperini, a NAACOS senior policy advisor, said NAACOS is continuing to advocate for continued changes to the triggering of CMS’ “extreme and uncontrollable circumstances” policy for the MSSP; the changes, some of which remove some costs related to COVID-19 from MSSP expenditures, are good but do not go far enough, she said.

“This is the start, not the end of this process,” she said.