tci Medicare Compliance & Reimbursement - 2019 Issue 2

Medicare Policy: ACOs: ‘Pathways to Success’ Reshapes MSSP

Get ready to transition over to the new program ASAP. Accountable Care Organizations (ACOs) take on risks to promote provider cooperation and innovation while saving both the patient and Medicare money. However, CMS suggested that some ACOs weren’t risking as much as they should to reap the rewards of the program — enter a completely redesigned Medicare Shared Savings Program (MSSP). Background: In August, CMS released an MSSP proposed rule with the overhaul catchphrase,“Pathways to Success,” which suggested numerous changes aimed at improving ACOs’ outcomes. The final rule, published in the Federal Register on Dec...

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