CMS Issues Medicare Shared Savings Program Rule

CMS issued a final rule to update the Medicare Shared Savings Program (MSSP), which governs the activities of more than 400 ACOs across the country. This rule represents the first significant update to the Medicare ACO program since the first rules were finalized in November of 2011. The 592-page rule makes numerous modifications to the ACO program, including:

• Creates a new "Track 3" for MSSP ACOs that looks very similar to the Pioneer ACO program model, including higher rates of shared savings, prospective assignment of beneficiaries, and the opportunity to use new care coordination tools;
• Streamlines data sharing between CMS and ACOs, which will allow ACOs to more easily access data on their patients;
• Establishes a waiver of the SNF 3-day stay requirement for those ACOs who opt into Track 3; and
• Refines the policies for resetting ACO benchmarks to help ensure that the program continues to provide strong incentives for ACOs to improve patient care and generate cost savings.