CMS Revamps Medicare ACO Program

The federal government seeks to pursue greater savings and an accelerated approach to value-based care through an overhaul of its programs for Medicare accountable care organizations.

The Centers for Medicare & Medicaid Services’ new “Pathways to Success” program seeks to speed up the process of providers assuming risk for costs and outcomes through the following changes from the agency’s current approach.

  • A reduction in how long participating ACOs can remain in the program without assuming some responsibility for their spending.
  • Modifications that CMS hopes will encourage physician groups to remain independent of hospitals and health systems.
  • Greater flexibility to innovate in exchange for participating in performance-based risk.
  • Permission to offer new incentives to patients to take greater responsibility for their own health.
  • Incorporation of regional spending differences when setting individual ACOs’ target spending and to foster greater alignment with Medicare Advantage programs.

Learn more about CMS’s new Pathways to Success Program for Medicare ACOs by reading this program announcement and the regulation detailing how the ACO program will change.

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