CMS Proposes Changes to Strengthen Shared Savings Program for ACOs

December 12, 2014 | Strategic Insights for Ambulatory Care


​The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule to update and improve the policies governing its Medicare Shared Savings Program for accountable care organizations (ACOs), states a December 1, 2014, CMS press release. According to CMS, the revisions affect several program areas, including beneficiary assignment, data sharing, available risk models, eligibility requirements, participation agreement renewals, and compliance and monitoring. Among other changes, the rule proposes to make several minor modifications to the eligibility requirements for ACO participation, to give ACOs the option of a longer lead time to transition to a two-sided performance risk model after the first agreement period, to revise step 2 of the assignment methodology to remove certain specialty types whose services are not likely to be indicative of primary care services, and to streamline the process for ACOs to access beneficiary claims data necessary for healthcare operations while retaining the opportunity for beneficiaries to decline to have their claims data shared with the ACO.

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