Final Rule Creates
Pathways to Success for the Medicare Shared Savings Program
Today, the Centers for
Medicare & Medicaid Services (CMS) issued a final rule that dramatically
redesigns and sets a new direction for the Medicare Accountable Care
Organizations or “ACOs.” ACOs are groups of healthcare providers that take
responsibility for the total cost and quality of care for their patients, and
in exchange they can receive a portion of the savings they achieve. To ensure
the ACO program delivers the most value, Pathways to Success is designed to
advance five goals: Accountability, Competition, Engagement, Integrity,
and Quality.
The Medicare Shared
Savings program (MSSP) launched in 2012 and currently over 10.4 million
beneficiaries in Fee-for-Service Medicare (of the 38 million total
Fee-for-Service beneficiaries) receive care from providers participating in a
Medicare ACO. Most Medicare ACOs currently do not face financial consequences
when costs increase, but Pathways to Success will change this. Having more
Accountable Care Organizations take on real risk, while offering them the
incentives and flexibility they need to coordinate care and innovate, is an
important step forward in how Medicare pays for value. Data on ACO
performance shows that over time ACOs taking accountability for costs perform
better than those that do not. As a result of today’s changes, the projected
savings to Medicare total $2.9 billion over ten years.
Invitations for a national
partner call will come out soon to walk through this final rule: “Pathways to
Success”
For more
information
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Friday, December 21, 2018
Final Rule Creates Pathways to Success for the Medicare Shared Savings Program
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