The Medicare Shared Savings Program Rulebook
Analysis of the Final Rule and Strategic Implications for Providers
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Topics: Medicare, Reimbursement, Finance, Payer and Regulatory Policy, Market Trends, Strategy, Accountable Care, Health Care Reform, Strategy Development, Planning
By reading this study, members will understand:
- The requirements for participation in the Shared Savings Program, including antitrust provisions
- Key elements of the financial model, including an analysis of the two tracks available to participants
- Quality performance thresholds and transparency requirements
- Key strategic implications for all participating providers
Executive Summary
Medicare has released the final rule for the Shared Savings Program, pressing the question of program participation for many hospitals, health systems, and physician organizations. This study reviews key provisions of the rule, including the method of patient assignment to ACOs, performance measures considered, method of bonus calculation, and application process.
It also examines the broader strategic implications of the structure of the Medicare Shared Savings Program—both for organizations that would like to participate within the next few years and those that prefer to eschew participation in the near term.
The Medicare Shared Savings Program Rulebook profiles the key elements of the financial model and quality performance thresholds as well as the strategic implications for providers.
Key Takeaways
