150th Interview: Tim Gronniger Discusses the Current Proposed Medicare Accountable Care Organization (ACO) Rule (October 3rd)

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Currently, CMS is accepting public comment on a proposed Medicare Shared Savings Program (MSSP), known more commonly as the Accountable Care Organization (ACO) program, rule.  The MSSP, created under the 2010 Affordable Care Act, is Medicare's flagship pay or performance program currently providing care to over 10 million Medicare beneficiaries.  MSSP or ACO performance, or to the extent the program has reduced Medicare spending growth, has been widely debated largely because CMS has failed to evaluate the program  Under this administration the program has come under substantial criticism.  The proposed rule, published this past August 17 in the Federal Register, is this administration's effort to improve the program's performance moreover by reducing the number of years an provider can participate in the program, from six years to two, without taking financial risk or participate in what are termed upside only contracts.  The administration argues absent financial risk providers do not fully engage in practice reforms to reduce spending.  This assumption is also widely debated.  Absent other substantial payment innovations, the success of the MSSP or ACO program is vital to the Medicare program, now forcasted to go bankrupt in 2026. 

During this 30 minute conversation Mr. Gronniger begins with a a brief overview of Caravan's work, he discusses or explains what success the ACO program has achieved to date and the program's background.  He moves onto discussing numerous elements of the proposed rule including earned shared savings percents, risk adjustment, aspects of financial benchmarking, low and high revenue ACOs, and beneficiary engagement and incentives, among others.     

Mr. Tim Gronniger is currently the Senior Vice President of Development and Strategy at Caravan Health.  Previously, he served as Chief of Staff and Director of Delivery System Reform at CMS.  Previous to that, Mr. Gronniger  was Senior Adviser for Health Care Policy for the White House Domestic Policy Council.  Before that he served as senior professional staff to the Ranking Member of the House Committee on Energy and Commerce, Rep. Henry Waxman (D-CA, now retired).  Mr. Gronniger began his career in Washington, D.C. at the Congressional Budget Office where he studied or scored Medicare and Medicaid legislation.  Mr. Gronniger holds a Masters in Public Policy and Health Services Administration from the University of Michigan and a BA in Biochemical Sciences from Harvard. 

The proposed ACO rule is at: https://www.federalregister.gov/documents/2018/08/17/2018-17101/medicare-program-medicare-shared-savings-program-accountable-care-organizations-pathways-to-success

For information concerning Caravan Health go to: https://caravanhealth.com/

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