Validate Health has aggregated mid-year benchmark files recently released by CMS in order to derive an estimated 2018 national assignable trend factor. These estimates can be used by ACOs to improve financial projection accuracy for 2018 final settlement prior to its release.
These results for 2018 are especially surprising for two reasons. First, the 2018 trend of 3.8% is record-breaking, being the highest for of years since MSSP program inception. Second, the previously estimated 4.3% trend, based on CMS’s suggested estimation methodology, is overly optimistic by 0.5%.
This difference is significant enough to turn an expected shared savings into a loss. (See section The Danger of Relying on CMS Estimates.)
The trend has increased steadily across all enrollment types since the MSSP program inception. ESRD expenditures has a disproportionately large jump among all enrollment types. So the Kidney Care First (KCF) and Comprehensive Kidney Care Contracting (CKCC) payment changes are now particularly relevant. They are an opportunity for ACOs to reduce expenditures below benchmark and capture shared savings for this population over the coming years.
Although the cumulative growth in the disabled population outpaced all other enrollment types, this impact is mitigated by the fact that typically these beneficiaries account for only 12% of the total assigned population.
Disability-focused initiatives should be considered to control this fastest trending sub-population.