he end of 2022 brings bad news for accountable care organizations. A 5% quality bonus for physicians
who successfully meet quality thresholds is slated to expire by the end of this year. This could be a huge cut for ACOs that are already under regulatory and financial pressure.There is a strong push to
extend the bonus as it can incentivize physicians to join ACOs.
Healthcare leaders worry that the sunset of this countable dollar will have a negative impact on their ability to hire and retain physicians. In a climate of declining margins and high operational costs,
not renewing this bonus can be a huge hit.
The bonus payment, brought into effect by the Medicare Access and CHIP Reauthorization Act, is essential to maintain the infrastructure required to meet quality thresholds and improve outcomes, according
to ACO leaders.
The current challenges faced by ACOs
Most hospitals have complicated and conflicting financial incentives with ACOs. The financial incentives of hospitals do not always intersect with the goals of ACOs. To align both and achieve cost savings
is an ongoing challenge for Accountable Care Organizations.
A huge number of ACOs still follow the Fee for Service (FFS) payment model. This can be a concern as the move to value is fraught with operational challenges. The risk adjustment model and quality
benchmarks are some of the major roadblocks hindering ACOs on their journey towards value based reimbursement.
As 2023 approaches, financial constraints and regulatory requirements will pose an even bigger challenge for ACOs. The quality bonus, if continued by decision-makers, will be a solace and a source of
dependable revenue when everything else is up in the air.
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