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January 3, 2019

ACO roundup: CMS finalizes rule to make ACOs take on more risk

Daily Briefing
    • CMS finalizes rule to make ACOs take on more risk. CMS on Dec. 21, 2018, finalized a rule to overhaul the Medicare Shared Savings Program (MSSP) and accelerate the pathway for ACOs to transition to two-sided risk models. Among other changes, CMS' final rule, called "Pathways to Success," will reduce to two years the amount of time ACOs can stay in MSSP without assuming risk by replacing MSSP's existing three tracks with two new tracks, called the BASIC Track and the ENHANCED Track. Both tracks will have five-year contract terms and require participants to take on downside risk, effectively eliminating CMS' upside-only Track 1 option. CMS finalized a one-time July 1, 2019, start date that will have a spring application period. CMS also will extend for six months current ACO agreements that are set to expire this year. Overall, the agency projected the changes will save $2.9 billion over ten years.
    • Next Gen ACOs produce $129M in savings, earn $200.5M in bonuses. CMS last month announced that Medicare Next Generation ACOs saved the agency $129 million in 2017 while earning an average of $3.3 million each in bonuses. According to Modern Healthcare, 32 of the 44 Next Generation ACOs earned bonuses in 2017—totaling $200.5 million—compared with 11 of the 18 Next Generation ACOs participating in the program's first year.
    • The ACA's been struck down. So why aren't more Republicans celebrating? Republican lawmakers have been trying to repeal the Affordable Care Act (ACA) since it became law in 2010, but their chances of doing so grew dim after Democrats won control of the House in this year's midterm elections. However, Republicans by and large haven't been cheering a recent court ruling that strikes down the law—a response experts say is because Republicans have a lot to lose, and no viable back-up plan, if the ACA is eradicated.

    From Advisory Board:

    • MACRA 101. Join us for 30 minutes on Thursday, January 31, at 3:00 p.m. ET where we'll break down MACRA's origins and provide an introduction to the two Quality Payment Program (QPP) tracks: the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (APM).

    Register Here

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