With ACO Advance Investment Payments Moving Forward, PCC Pushes for Adoption of Hybrid Models

Late last month, the Centers for Medicare and Medicaid Services (CMS) announced that 19 new accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) will participate in a new Advance Investment Payment (AIP) initiative in 2024. Usually consisting of clinicians, health systems and private practices, the goal of ACOs is to improve patients’ health by providing them with high-quality, coordinated health care. Responsive to Better Health – NOW's previous advocacy, 19 new ACOs will receive over $20 million in one-time resources in order to hire community health workers, use health assessment and screening tools and improve health care quality for rural and underserved communities.

Because of MSSP’s potential to improve the health of tens of millions of Americans, PCC, NAACOs and 27 other organizations have encouraged CMS to go further and establish an ongoing primary care hybrid payment option within MSSP. Providing access to health care to about half of Medicare beneficiaries, ACOs have the opportunity to improve the health of nearly 1 in 4 Americans. Moreover, as the largest permanent ACO program in the country, MSSP is in a unique position to increase that number.

What’s more, PCC discussed the benefits of “primary care-centric” ACOs in a meeting with the Biden Administration’s Office of Management and Budget. Not only do ACOs perform better the longer they are in the MSSP program, but ACOs with more primary care physicians outperform ACOs led by other specialties. Evidence suggests that these “primary care-centric” ACOs deliver more primary care services and help patients avoid unnecessary and costly hospitalizations and emergency room visits.

For these reasons, PCC urges the administration to support broader primary care clinician participation in Medicare ACOs by standing up a hybrid primary care payment option in the Medicare Shared Savings Program.