Value-Based Platform Will Join CMS Incentive Program to Support Rural ACOs

Value-based care platform Signify Health announced plans to participate in the CMS Advance Investment Payments (AIP) incentive program to support providers in rural and underserved communities.

Rural populations have a shorter life expectancy than urban populations and face more barriers to healthcare access. More than 600 rural hospitals are at risk of closing, while 136 rural facilities closed between 2010 and 2021.

In addition to hospital closures, social determinants of health barriers often lead to lower preventive healthcare utilization among rural communities.

Healthcare providers in rural and underserved communities also face challenges when it comes to delivering care, such as staffing shortages, rising costs, and a growing Medicare population.

CMS introduced the AIP incentive program to help mitigate these challenges for providers in rural communities. The program, which begins January 1, 2024, offers advance funding to providers to help them implement the infrastructure, technology, and resources needed to succeed in the Medicare Shared Savings Program (MSSP).

CMS finalized the program’s implementation in the 2023 Medicare Physician Fee Schedule (PFS) final rule.

“The expectation is that advance investment payments will provide an opportunity for many entities in rural and underserved areas to join together as ACOs, build the infrastructure needed to succeed in the program, and promote equity by holistically addressing beneficiary needs, including social needs,” the rule stated.

Accountable Care Organizations (ACOs) that are new to the MSSP and are determined to be low revenue and inexperienced with performance-based risk Medicare ACO initiatives can receive a one-time fixed payment of $250,000 and quarterly payments for the first two years of the five-year agreement period.

Federally qualified health centers (FQHCs) and rural providers participating in ACOs supported by Signify Health will reap the benefits of the AIP program and achieve shared savings.

“We recognize the obstacles that rural and underserved communities face and are committed to making it possible for providers who care for the underserved to participate in the Medicare Shared Savings Program,” Laurel Douty, executive vice president of value-based care growth and business development for Signify Health, said in the press release. “These investments are critical to achieving CMS’s goal to have every Medicare member in an accountable care relationship by 2030.”

The AIP program is modeled after the ACO Investment Model (AIM) that provided upfront loans for rural providers to participate in the MSSP. The model generated $382 million in savings for CMS over three years, the press release noted. Caravan Health, now owned by Signify Health, sponsored 21 of the 41 ACOs in AIM and helped improve quality and cost savings for its participants.

In March 2022, Signify Health acquired Caravan Health, which provides technology services to support providers and practices in ACOs. The acquisition created one of the largest national networks of providers involved in value-based and risk-based payment models.