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CMS Finalizes Changes to Medicare Shared Savings Methodology

In a new final rule, the Centers for Medicare & Medicaid Services (CMS) made changes to the Medicare Shared Savings Program (MSSP) aimed at helping more accountable care organizations (ACOs) successfully participate in the program.

The rule establishes a new, phased-in benchmark methodology for determining shared savings payments. This methodology will incorporate regional, fee-for-service expenditures for establishing and adjusting benchmarks for ACOs that extend their initial, three-year MSSP participation with a second or subsequent agreement period beginning on or after Jan. 1, 2017. Previously, the methodology used a national trend factor to determine these benchmarks.

With these changes, CMS hopes to better reward ACOs that outperform other such organizations in their region on measures of cost and quality of care. CMS will phase in this new methodology to give participants time to make any necessary adjustments.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Matt Buechner is the policy and advocacy associate for America's Essential Hospitals.