Health Affairs October 14, 2021
Medicare’s share of gross domestic product, projected to grow by over 50 percent by 2050, is among the federal government’s leading long-term fiscal challenges. Alternatives to fee-for-service reimbursement, such as accountable care organizations (ACOs) and episode-based payments, offer the promise of “bending the trend” through provider-driven reductions in low-value care rather than benefit reductions or fee cuts.
The Affordable Care Act (ACA) attempted to transform payment models through two vehicles. First, the ACA established what is now a multi-track Accountable Care Organization program—the Medicare Shared Savings Program (MSSP). Second, it also established the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare & Medicaid Services (CMS). CMMI was charged with developing, launching, and evaluating new models. A...
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