- CMS revealed Monday a final rule on the Medicare Shared Savings Program (MSSP) that changes how it determines whether accountable care organizations (ACOs) are saving money with the goal of correcting financial reconciliation calculations.
- Timeframes and other criteria to challenge CMS' initial determination of shared savings or shared losses were established. ACOs now have up to four years to make the appeal.
- A recent study published in the New England Journal of Medicine recently found ACOs reduced spending by 1.4% in 2013 in comparison with a control group of non-accountable care organizations. ACOs were also found to have maintained or improved certain performance measures for quality of patient care.
The new methodology will be phased in for ACOs entering contract periods on or after Jan. 1, 2017.
The agency will adjust cost benchmarks by replacing the national trend factor with regional data for when an ACO signs up for a second or subsequent contract period. The rule also allows ACOs under Track One "to apply to renew for a second agreement period under a two-sided model (Track Two or Track Three)," according to a fact sheet.
CMS finalized changes to the MSSP in June 2015 that adopted the third-track option and allowed providers to enter a second three-year period in the first track.
There are 434 ACOs that are still in a track in which they can earn bonuses for meeting cost and quality targets without the risk of a penalty, Modern Healthcare reports.
"Today’s changes will encourage more physicians to improve patient care by joining Accountable Care Organizations, while also refining how the program measures success, so that current participants are better rewarded for quality,” CMS Acting Administrator Andy Slavitt said in a statement.
“These new flexibilities are based on significant input from participants and will help physicians prepare for the new Quality Payment Program, part of bipartisan legislation Congress passed last year repealing the failed Sustainable Growth Rate,” he added.