How Will Changes to MSSP Impact Your ACO?

At the end of January, the Centers for Medicare and Medicaid Services (CMS) proposed a rule change that would significantly change the way shared savings is measured for accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP).

The agency’s announcement said, in part, that it had ” released a proposed rule to update the methodology used to measure the performance of [ACOs] in the [MSSP]. Today’s proposal builds on the momentum of growth in the [MSSP] and charts a path for long-term sustainability by improving the long-term incentives for ACOs as they continue to provide efficient, high quality healthcare to Medicare beneficiaries.”

So what does that mean for your ACO?

In general, the new rule would overhaul the process by which MSSP benchmarks are set. Rather than ACOs competing against their own baseline and needing to continuously improve upon their own best results, the model will transition, over time, to data that is based on the ACO’s regional service area. Under the new rule, ACOs would have their data compared to other, similar providers in the area rather than against a baseline which would require unsustainable perpetual improvement. The proposed rule change seems to signal a genuine desire to develop a shared savings model that is sustainable for ACOs in every part of the country.

The proposed rule change will be open for public comment until March 28 as CMS develops the final rule structure.

The need, therefore, to continuously monitor fee-for-service expenditure trends both within your ACO and regionally will become even more important as shared savings determinations are increasingly based on this data. Salient ACO is a turnkey analytics solution that provides your team with meaningful intelligence to rapidly evaluate, remediate, and continuously improve overall population health, quality of medical care, and financial performance — as well as compare your performance to other ACO networks.

Learn more about how Salient ACO can help your healthcare organization achieve shared savings.

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