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MSSP Accountable Care Organizations Moving to Risk in 2018

The share of MSSP ACOs participating in downside financial risk tracks increased to 18 percent in 2018 with the help of the new MSSP Track 1+.

Medicare Shared Savings Program (MSSP) and accountable care organizations (ACOs)

Source: Thinkstock

By Jacqueline LaPointe

- According to a new fact sheet from CMS, the Medicare Shared Savings Program (MSSP) will see some fresh faces in 2018, as well as more accountable care organizations (ACOs) entering downside financial risk tracks.

The federal agency reported that 124 ACOs joined the Medicare Shared Savings Program, bringing the total number of participating organizations to 561 ACOs in 2018.

The remaining MSSP ACOs in the class of 2018 included 65 organizations that renewed their agreements in 2018 and 372 organizations that continued with the program, but were not required to renew this year.

MSSP launched in 2012 with just 220 ACOs covering 3.2 million beneficiaries. The recent additions will now bring the total number of assigned Medicare fee-for-service beneficiaries to 10.5 million.

Most of the ACOs participating in 2018 will join the upside-only financial risk track of the program. About 82 percent of the organizations are in MSSP Track 1, meaning providers will not have to repay CMS for potential financial losses.

Track 1 has been the most popular option for MSSP ACOs. Last year, 438 organizations participated in the upside-only track, representing 91 percent of all MSSP ACOs.

While Track 1 continues to dominate MSSP participation, more ACOs are joining other tracks with downside financial risk structures in 2018. A total of 8 organizations will be Track 2 ACOs, up from 6 organizations last year, and 38 organizations will be Track 3 ACOs, up from 36 organizations last year.

More MSSP ACOs will also be assuming downside financial risk under the program because of a new track introduced in 2018. This is the first year that ACOs can join Track 1+, an intermediate track that allows organizations to assume downside financial risk and qualify for Advanced Alternative Payment Model incentives under MACRA without taking on high levels of risk as in Tracks 2 and 3.

Fifty-five MSSP ACOs signed up for Track 1+ in 2018. CMS intends for the track to serve as a ramp-up to additional financial risk in the near future.

CMS also reported that 58 percent of MSSP ACOs will include a combination of physicians, hospitals, and other facilities in 2018.

Just 30 percent will include physicians only and another 12 percent include federally qualified health centers and rural health centers.

The National Association of ACOs (NAACOS) recently welcomed new and returning MSSP organizations.

“ACOs play a critical role in transforming our nation’s healthcare system through value-based care. The growth of ACOs in 2018 shows the continued commitment from the Administration to increase value in the Medicare program through ACOs,” stated Clif Gaus, ScD, President and CEO of NAACOS. “ACOs demonstrate a commitment to achieving a healthier population and focus on quality, cost, wellness, and outcomes as their primary goals. We’re pleased to welcome the new and continuing ACOs.”

He also pointed out that the increase in ACOs taking on downside financial risk indicated that the MSSP is stepping in the right direction.

“We are pleased to see more ACOs moving into two-sided models,” Gaus explained. “This growth is an encouraging sign that more ACOs are preparing to take on risk, but it’s vital to recognize all the time and effort for these ACOs to be ready to assume risk. We need to continue to improve the ACO program as a whole to provide the stability and demonstrated success necessary for ACOs to feel confident to enter into these risk-based ACO models.”

The industry group added that CMS expects to announce participation data for the Next Generation ACO model soon. The model builds on the MSSP and Pioneer ACO program and includes higher financial risk and shared savings opportunities.

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