CMS has released a proposal aimed at strengthening the Medicare Shared Savings Program, which reflects input from accountable care organizations participating in the program, consumer groups and other stakeholders.
Here are six things to know about CMS' proposal.
1. CMS is proposing to give MSSP ACOs longer "lead time" in transitioning to a two-sided model that involves sharing in financial losses in return for the opportunity for a higher share of savings.
2. Under its proposal, CMS is seeking to refine the process for assigning Medicare beneficiaries to ACOs by placing greater emphasis on primary care services.
3. CMS is proposing to create "track 3," which is a new two-sided risk model. Track 3 would implement elements from the Pioneer program, including higher rates of shared savings.
4. CMS is seeking comment on alternative methodologies that could be used to determine shared savings and losses in a way that is gradually more dependent on the ACO's success in being more cost efficient relative to its local market.
5. CMS is proposing providing ACOs access to Medicare beneficiaries' claims data necessary for quality improvement in a more efficient manner, while still letting beneficiaries decline having their claims information shared with the ACO.
6. CMS Administrator Marilyn Tavenner said, "This proposed rule is part of our continued commitment to rewarding value and care coordination — rather than volume and care duplication."
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