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Second Opinion

Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

Medicare Release Proposed Rule for ACOs

December 5, 2014—The Centers for Medicare and Medicaid Services (CMS) Dec. 1 released proposed regulations to update the Medicare Shared Savings Program (MSSP). Established by the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152), the MSSP incentivizes providers working in accountable care organizations (ACOs) to share savings if the ACO meets certain quality targets and reduces the costs to care for an assigned patient population.

In the existing rules, MSSP ACOs can enroll for a one-sided risk contract, meaning the ACO shares in the savings but not in any losses, for the first agreement period. Currently, the majority of MSSP ACOs are enrolled in this model. After the initial period, ACOs must transition to a two-sided risk model. The proposed rule creates an option for ACOs that meet certain quality and financial benchmarks to continue in a one-sided risk model in subsequent contract years, although with a reduced sharing rate.

Additionally, CMS is proposing a new model that would allow ACOs to have increased savings and a better understanding of their patient population if the ACO will take on more risk. 

CMS is also requesting comments on data sharing requirements, benchmark calculations, and various participation requirements, which are due by Feb. 6, 2015.

Contact:

Mary Patton Wheatley, M.S.
Director, Health Care Affairs
Telephone: 202-862-6297
Email: mwheatley@aamc.org

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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.


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For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org