28 Jun Medicare Shared Savings Program: Implementing the CY 2023 Final Rulemaking Policies
The CY 2023 Final Medicare Physician Fee Schedule rule included a number of new policies aimed at addressing issues in the Medicare Shared Savings Program (MSSP). These include the establishment of the Advanced Incentive Payment (AIP) program to provide up-front funding for new ACOs to support the significant investments needed to operate the program; establishing smoother glidepaths for ACOs transitioning from upside-only to downside risk; and the prior savings adjustment to the benchmarking methodology. The most significant changes are expected to begin in 2024. Of particular interest is how ACOs are preparing for these changes and how they expect the changes will impact MSSP in the long term.
On June 28, the Task Force hosted hear Bryan Smith, Principal Performance Partner at Premier; Travis Broome, Senior Vice President for Policy and Economics at Aledade; and Ashley Ridlon, Vice President of Health Policy from Evolent who spoke to the following questions and topics:
• What operational changes are ACOs making this year to prepare for the changes coming in 2024?
• What challenges are organizations facing in terms of these policy changes? Conversely, what opportunities do they afford for operations?
• Are there any early impressions/lessons from the implementation of provisions that went into effect this year (2023)?
• Overall, how are organizations responding to CMS’ efforts to create more opportunities to join MSSP (AIP program, extended upside-only risk options, etc.)
• How are CMS’ efforts to address the rural glitch and benchmarking ratchet effect impacting ACOs? What more should be done for long-term MSSP participants.
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