Medicare users could soon lose perks they love -- like choosing their own doctor

[Yo_Mama_Been_Loggin]

One of the benefits of traditional Medicare is the flexibility of choosing your doctor and the ease of seeing specialists. But that could be about to change.

Healthcare providers under Medicare could soon be tightening their spending by scaling back care or requiring more prior authorizations, as the Centers for Medicare and Medicaid Services (CMS) pushes to have all beneficiaries in cost-cutting models by 2030.

The CMS Innovation Center earlier this year released a new strategic goal to move Medicare and Medicaid beneficiaries to accountable care arrangements with providers who assume the financial risk of providing care, a CMS spokesperson said. CMS has said it aims to have all people with traditional Medicare in such arrangements by 2030.

Under these arrangements, groups of doctors, hospitals and other healthcare providers work together to coordinate patient care. The accountable care organizations then are financially responsible for the care provided — getting bonuses if spending is lower than targeted, and penalties if spending is higher.

https://www.msn.com/en-us/money/personalfinance/medicare-users-could-soon-lose-perks-they-love-like-choosing-their-own-doctor/ar-AA1NKACN

[wcmagumba]

1. This will sux...Thanks again rump and thuglicans...

[riversedge]

2. Medicare users could soon lose perks they love -- like choosing their own doctor Getty Images

[bucolic_frolic]

3. They're stripping the intelligence out of everything

[Silent Type]

4. Darn that Obama and the Affordable Care Act. Yep, that's where ACOs came from and they've been operating for over

a decade now.

AI Overview
"Medicare Accountable Care Organizations (ACOs) officially started in 2012 when the first groups were selected to participate in the Medicare Shared Savings Program (MSSP), a program authorized by the Patient Protection and Affordable Care Act (ACA) of 2010. While the concepts for ACOs were being discussed and established in the years prior, including in 2006 and the late 2000s, the actual launch of the program and the selection of the first ACOs occurred in 2012. "

[cliffside]

5. Jan 15, 2025 - CMS announces increase in accountable care relationships ...

https://www.aha.org/news/headline/2025-01-15-cms-announces-increase-accountable-care-relationships

"The Centers for Medicare & Medicaid Services announced Jan. 15 that 53.4% of people with Traditional Medicare are in an accountable care relationship with a provider, a 4.3% increase from last year. The agency said it is the largest increase since it began tracking accountable care relationships.

For 2025, CMS approved 228 applications for the Medicare Shared Savings Program, bringing the total number of accountable care organizations participating in MSSP to 476. Approved applicants included 55 new ACOs and 173 renewing or reentering ACOs, the most in the program's history.

CMS said there was also a 16% increase from last year in federally qualified health centers, rural health clinics and critical access hospitals participating in the MSSP. In addition, 103 ACOs are continuing participation in CMS' ACO Realizing Equity, Access, and Community Health Model, and 78 kidney contracting entities and 15 CMS Kidney Care First Practices are continuing participation in the Kidney Care Choices Model.

In other ACO news, the CMS Innovation Center Jan. 1 launched the ACO Primary Care Flex Model with 24 ACOs participating jointly in the MSSP. The ACO PC Flex Model provides a one-time advanced shared savings payment, monthly prospective primary care payments and incentives to support team-based care approaches to medical and social needs.