- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Stephen Nuckolls: 2 Years Isn't Enough Time for an ACO to Take on Risk
The proposed changes to the Medicare Shared Savings Program that move accountable care organizations (ACOs) to take on risk in just 2 years is not going to be enough time for most ACOs, although some may be ready in that time, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.
The proposed changes to the Medicare Shared Savings Program that move accountable care organizations (ACOs) to take on risk in just 2 years is not going to be enough time for most ACOs, although some may be ready in that time, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.
Transcript
Previous research has shown that ACOs that are doing it longer, perform better. Do you think the shorter 2-year timeline to take on risk provides enough time for ACOs to figure it out?
[CMS has] drastically shortened the time period from 6 years to 2 years. I know for our ACO, we did not achieve savings in the first 3-year contract period, and if we had been then required to take on risk after 2 years after just seeing just the first year’s results, I don’t think our ACO would still be an ACO. We would have dropped out of the program.
I don’t believe that’s enough time. And I think we were able to move a lot more quickly as a small ACO than some of the larger systems. I think ACOs are going to need more time to get ready for risk.
Some may be ready in that period of time, but there are many different things that go on with how you formulate the benchmark and how the benchmark impacts local markets, and it’s less about being ready for risk and knowing what the risks are, evaluating the risks to see what your odds of success are and what the probabilities are.
Blister Packs May Help Solve Medication Adherence Challenges and Lower Health Care Costs
June 10th 2025Julia Lucaci, PharmD, MS, of Becton, Dickinson and Company, discusses the benefits of blister packaging for chronic medications, advocating for payer incentives to boost medication adherence and improve health outcomes.
Listen
Sequencing CAR T and Bispecifics for Multiple Myeloma: Tyler Sandahl, PharmD
July 8th 2025Tyler Sandahl, PharmD, a clinical pharmacist at Mayo Clinic, explains that sequencing novel multiple myeloma therapies with CAR T-cell therapy is generally prioritized first for eligible patients, while bispecific antibodies are reserved for later lines or for patients unable to tolerate CAR T.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
Driving Value via Outcomes-Based Pricing and EHR Interoperability: Tyler Sandahl, PharmD
July 7th 2025Tyler Sandahl, PharmD, a clinical pharmacist at Mayo Clinic, discussed the complexities of alternative payment models for chimeric antigen receptor T-cell and bispecific therapies and the need for improved data sharing in cancer care.
Read More
Insurance Gaps Threaten Cancer Treatment Success
July 7th 2025Access to and affordability of immune checkpoint inhibitors, which can be lifesaving if patients receive them on time and under optimal circumstances, continue to top the list of reasons behind outcomes disparities for patients who have private insurance vs those who remain uninsured.
Read More
