September 11, 2023
Payers | Tea Leaves
  • The Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Shared Savings Program (MSSP) saved a net $1.8 billion in 2022 for accountable care organizations (ACOs), the second-highest annual savings since the program began 10 years ago. According to a news release, it is also the sixth consecutive year the program has generated savings. In 2021, CMS said it saved Medicare $1.66 billion. ACO leaders praised the program Thursday, calling the MSSP a success for all parties. (Articles here and here)
  • Cigna is eliminating prior authorization requirements from 600 diagnostic codes in a bid to streamline the experience for both members and providers. The 600 codes represent nearly 25 percent of those requiring prior auth, Cigna said in an announcement. Cigna said this builds on several years of work to ease prior authorization barriers; since 2020, the company has removed prior auth on about 1,100 codes. Cigna said that with the latest update, prior authorization applies to less than 4 percent of services for most of its members. (Articles here and here)