Premier Statement on the Medicare CY 2023 Physician Fee Schedule Proposed Rule

By Soumi Saha, Senior Vice President of Government Affairs, Premier Inc.

Premier applauds CMS for addressing several aspects of the Medicare Shared Savings Program (MSSP) that has historically limited provider participation. As Premier has long advocated, we must ensure that providers in Accountable Care Organizations (ACOs) have an adequate budget, and that we create incentives for rural and other vulnerable providers to move to value. The new proposed rule enhances value-based incentives by:

• Providing up-front shared savings payments to small and rural providers who participate in ACOs;
• Incorporating health equity into quality scores;
• Addressing race-to-the-bottom benchmarks by accounting for ACO trends in spending and the ACOs regional penetration; and
• Improving the risk adjustment methodology to account for medically complex beneficiaries.

We are disappointed, however, that CMS continues to set a low and high revenue distinction for ACOs as this can limit innovation and disincentivize cross-continuum collaboration.