Assurance for Rural ACOs: NRHA Submits CMS Comments

In August, we first reported that the Centers for Medicare and Medicaid Services (CMS) had proposed a major rule change for Accountable Care Organizations (ACOs), one that would have a huge impact on these providers in rural areas.

The proposed rule would require all providers in the program take on risk sooner, cutting the time ACOs can remain in the program without assuming risk from six years to only two years. Many rural providers are in a “Track 1” ACO which allows for potential shared savings, but do not assume risk for a high cost year. Rural providers spend significant resources to participate in an ACO, including increased cost of data analytics and training for providers, which have led to improved patient care and decreased costs for CMS. These participation costs are a significant source of risk already for rural providers, especially those with razor thin margins.

The push toward risk is not only ill-conceived but is also unnecessary for rural providers participating in the ACO program. Even without taking on “risk,” as defined by CMS, rural ACOs have returned savings to CMS while improving patient care.

This week, after many discussions with members participating in ACOs, NRHA submitted its comment letter to CMS, outlining our recommendations to improve the proposed rule to allow financially vulnerable rural providers an opportunity to participate in the program. In the letter, we urge CMS to maintain a one-sided risk option for rural and safety net providers, applying their rural strategy to this proposed rule to prevent rural ACOs from disappearing.

We appreciate the continued commitment from CMS to the needs of the 62 million patients living in rural America, and look forward to our continued collaboration with the agency to improve health care access and quality throughout rural America.

To read our comment letter in full, visit our regulatory comment letters here.

To read the rule in full, visit CMS website here.
 

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