Original Medicare Shared Savings Program (MSSP) benchmarks were determined by historical accountable care organization (ACO) spending.

Starting in 2017, the Centers for Medicare and Medicaid Services introduced a regional adjustment that blends an ACO’s historical spending with the average spending in its region to address concerns about unequal benchmarks for ACOs in the same market.

According to Peter Lyu and coauthors, the introduction of regional spending into the MSSP benchmarks "fundamentally altered participation incentives."

The coauthors note that ACO and practice-level participation in the MSSP increasingly shifted to providers with lower spending in their region after the introduction of regionalized benchmarking that rewarded such selection.

Their subgroup analysis shows the largest effects were among convener-involved ACOs.

"Importantly, these findings do not imply that the role of convener organizations is necessarily problematic," the authors note. "To the contrary, we found no evidence of strategic practice-level selection behavior among convener-involved ACOs, as selective participation was driven by ACO-level exit."

Today in Forefront, Jennifer Bright and coauthors provide recommendations on how the Centers for Medicare and Medicaid Services (CMS) can ensure patient experiences and perspectives are considered in decision making as it relates to the Medicare Drug Price Negotiation Program.

Lauren R. Gilbert and Omolola E. Adepoju examine some of the challenges associated with accessing Narcan over the counter, including cost barriers and stigmas associated with the drug.

Read more on Forefront and learn more about how you can contribute to the publication.

Andrew Anderson, PhD, an assistant professor at the Tulane School of Public Health and Tropical Medicine, is the first graduate of HEFT to publish work in Health Affairs. Be sure to check out Anderson’s other new releases:

Andrew’s study, titled "The Costs Of Disparities In Preventable Heart Failure Hospitalizations In The US South, 2015-17," was published in our May 2023 issue.
Andrew has also authored another piece in Forefront titled "The High Costs Of Ignoring Health Inequities."
Andrew is featured in A Health Podyssey to discuss his recently published paper on preventable heart failure hospitalizations.
Finally, Andrew will speaking in an upcoming Lunch And Learn event on the topic of advancing racial equity in scholarly publishing of health policy. Join us on Tuesday, May 23.

About Health Affairs

Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.

Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.

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