In a letter submitted March 28, the AHA continued to urge the Centers for Medicare & Medicaid Services (CMS) to modify the shared savings determination in the Medicare Shared Savings Program so that more accountable care organizations (ACO) can share in more of the savings they generate.

“This will allow them to continue to invest in the program and give ACOs adequate tools to coordinate and manage care,” wrote AHA Executive Vice President Tom Nickels, commenting on a proposed rule that would change how the program’s financial targets are calculated. “In addition, while we are pleased that CMS continues to pursue improvements to the MSSP, it is unclear whether the proposals included in this rule will offer more than an incremental improvement in the program’s ability to attract new and renewing ACOs.”

The AHA also voiced concern with the agency’s proposal to define the circumstances in which it would reopen a determination of ACO savings and losses to make corrections. “It seems to provide CMS with a blank check to reopen determinations and potentially recoup funds from an ACO, in some cases after the ACO’s contract with the MSSP is complete and/or due to errors the ACO did not commit,” the AHA said.