CMS Redesigns Shared Savings Program

ACOs asked to commit to five years on one of two tracks

Late Thursday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would redesign the Medicare Shared Savings Program’s participation options by offering eligible accountable care organizations two tracks, which they would agree to participate in for at least five years.

A BASIC track would allow eligible ACOs to participate under a one-sided, upside-only agreement for one to two years and then incrementally phase in higher levels of risk. At the highest level of risk, the BASIC track would qualify as an Advanced Alternative Payment Model under the Quality Payment Program.

CMS also would offer an ENHANCED track based on the program’s existing Track 3. The changes would apply for agreement periods beginning on July 1, 2019 and in subsequent years. The current Track 1, Track 1+ and Track 2 would be discontinued for future applications.

“The proposed rule fails to account for the fact that building a successful ACO, let alone one that is able to take on financial risk, is no small task; it requires significant investments of time, effort and finances,” said AHA Executive Vice President Tom Nickels in a statement. “Hospitals and health systems must build upon their current infrastructure, which entails forming new and different contractual relationships and incentivizes successful strategies.”

Comments on the rule are due October 16.

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