April 09, 2020

MedPAC Votes to Support ACO Assignment Recommendation to HHS Secretary

The Medicare Payment Advisory Commission (MedPAC) met via videoconference April 2 to recommend that the HHS secretary should use the same set of national provider identifiers (NPIs) to compute both performance year and baseline assignment for accountable care organizations (ACOs) in the Medicare Shared Savings Program.

The commission discussed the future of value-based payment (VBP) in Medicare and options for increasing its effectiveness. MedPAC staff explained that Medicare Advantage and ACOs need to be improved as vehicles for VBP, with these entities paying providers in ways to control cost and improve quality, such as upside and downside risks. The commission will continue to focus on VBP as a priority in future work.

The commission also continued its discussion on maintaining and increasing savings from ACOs. Staff presented findings that show unwarranted shared savings payments to ACOs could put Medicare savings at risk and that, in an effort to avoid potential for selection, NPI-based benchmarks may most accurately capture historical spending.