tci Medicare Compliance & Reimbursement - 2018 Issue 17

Review 5 Major Changes in the MSSP Proposed Rule

Hint: CMS wants ACOs to ramp up their risks. If you’re considering joining an Accountable Care Organization (ACO) in 2019, you may want to wait until CMS finalizes its new proposed rule on the Medicare Shared Savings Program (MSSP). Guidance suggests ACOs will have a lot more to balance if the swaps and additions are a go — and following the new rules may prove challenging. Background: In August, CMS released a revamp of its MSSP called “Pathways to Success,” which tones down one-sided risk models while promoting two-sided ones, putting more onus on the ACO...

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