In a new policy research brief by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative, “Medicare’s Accountable Care Organization Regulations: How Will Medicare Beneficiaries who Reside in Medically Underserved Communities Fare” the authors examine the impact on medically underserved Medicare beneficiaries of the Centers for Medicare and Medicaid Services (CMS’) proposed rule implementing the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs). The report finds that the regulation excludes from the anticipated benefits of ACO growth over 1.4 million Medicare beneficiaries who receive their primary care from federally qualified health centers (FQHCs). The exclusion arises from CMS’ interpretation of the law that excludes patients whose physicians practice as part of health care teams that bill globally for their care, despite the fact that health care teams are essential to overcome the impact of severe physician shortages in medically underserved communities.
The report is authored by Sara Rosenbaum and Peter Shin.