CMS Final ACO Rule: Extensively Restructures the Program & Transfers More Risk

The Centers for Medicare and Medicaid Services (CMS) has issued a final rule that will overhaul the Medicare Shared Savings Program, which is the program established by the Affordable Care Act (ACA) and launched in 2012 under which the vast majority of Medicare’s Accountable Care Organizations (ACOs) operate. CMS says the new direction of the program is to encourage ACOs to transition to performance based risk more quickly. However, the rule’s overall average projection is to save the program approximately $2.9 billion over 10 years relative to a baseline that assumes the prior program regulations remained in effect through this ten-year period. For more details, see today’s second Financial Feature.