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  • Washington Highlights

    AAMC Signs Community Letter to CMS on ACO Policies for Anomalous Spending


    Phoebe Ramsey, Director, Physician Payment & Quality

    The AAMC Apr. 29 signed a value-based care participating provider community letter (PDF) to the Centers for Medicare & Medicaid Services (CMS) requesting the agency make policy changes to hold accountable care organizations (ACOs) harmless when they identify anomalous durable medical equipment spending in the Medicare program. The letter followed recent analysis discovering a significant increase in catheter spending between 2021 to 2023, attributed to just 10 suppliers and not accounted for in ACO financial targets. Specifically, the letter urged the CMS adopt policies to hold ACOs harmless for anomalous spending, including the outlier catheter expenditures, in recognition of the role providers in ACOs play in delivering value-based care, in part through stewardship of the Medicare program.