Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Medicare Shared Savings Program

More Groups Want to Extend Medicare Shared Savings Program Deadline

January 23, 2019 - Eleven healthcare industry groups are supporting the National Association of ACOs’ (NAACOS) call for CMS to extend the Feb. 19 application deadline for the Medicare Shared Savings Program (MSSP). CMS announced earlier this month that the application cycle for the MSSP’s next iteration will launch Jan. 22. Accountable care organizations (ACO) wanting to participate in the...


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67% of MSSP ACOs May Be High-Revenue Under Pathways to Success

by Jacqueline LaPointe

Over two-thirds of Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) would qualify as high-revenue organizations under the new Pathways to Success initiative, a recent Leavitt Partners analysis...

CMS Announces Feb 19 Deadline for Pathways to Success Applications

by Jacqueline LaPointe

Accountable care organizations (ACOs) can start their Pathways to Success applications to participate in the initiative replacing the Medicare Shared Savings Program (MSSP) in the summer of 2019. The organizations will have between Jan. 22...

ACO Financial Risk Rules for Pathways to Success Raise Concerns

by Jacqueline LaPointe

Leading healthcare industry groups are concerned that the overhaul of the Medicare Shared Savings Program (MSSP) will impede the transition to value-based care. On December 21, 2018, CMS finalized changes to the largest Medicare...

CMS Overhauls MSSP by Finalizing Pathways to Success for ACOs

by Jacqueline LaPointe

CMS recently finalized an overhaul of the Medicare Shared Savings Program (MSSP), which will require accountable care organizations (ACOs) to assume downside financial risk sooner. The MSSP is the largest Medicare ACO program, boasting...

MSSP Accountable Care Organizations Saved Medicare Nearly $2.7B

by Jacqueline LaPointe

Accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) saved more than previously thought, according to a new analysis. The updated analysis of MSSP ACO savings from the National Association of ACOs (NACCOS)...

36% of ACOs Consider Quitting MSSP Under New Proposed Rules

by Jacqueline LaPointe

Over one-third of accountable care organizations (36 percent) said they are unlikely to continue with the Medicare Shared Savings Program (MSSP) if the proposed overhaul is finalized, a recent survey showed. Only 48 percent of ACO leaders...

Time Helps Accountable Care Organizations Realize Savings in MSSP

by Jacqueline LaPointe

Experience is a key factor to realizing greater cost savings in the Medicare Shared Savings Program (MSSP), a new Avalere analysis found. Accountable care organizations (ACOs) in the MSSP for four or more years generated nearly all of the...

Policymakers Concerned with ACO Shared Savings Under Updated MSSP

by Jacqueline LaPointe

The House Committee on Ways and Means recently voiced concerns that proposed changes to the shared savings arrangements under the Medicare Shared Savings Program (MSSP) overhaul would harm accountable care organizations (ACOs). In a...

MSSP ACOs Saved $1.84B, Nearly Double CMS Estimate, Study Finds

by Jacqueline LaPointe

CMS estimates that accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) saved $954 million from 2013 to 2015. However, a new Dobson DaVanzo & Associates analysis, commissioned by the National Association...

More MSSP ACOs Saved Money, Earned Shared Savings in 2017

by Jacqueline LaPointe

Accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) generated about $314 million in net Medicare savings in 2017, according to new MSSP performance data from CMS. In 2017, 472 ACOs in the largest Medicare...

CMS to Offer More Flexibility to Risk-Bearing ACOs, Verma Says

by Jacqueline LaPointe

Federal regulations and rules are commonly cited as barriers to implementing value-based reimbursement models. The rules can prevent care coordination and appropriate transitions of care, which negatively impact an accountable care...

Leading Accountable Care Organization Group Opposes MSSP Overhaul

by Jacqueline LaPointe

The proposal to overhaul the Medicare Shared Savings Program (MSSP) would significantly harm the accountable care organization (ACO) movement, the National Association of ACOs (NAACOS) recently stated. “The administration’s...

CMS Plans to Transform MSSP to Encourage ACOs to Assume More Risk

by Jacqueline LaPointe

CMS recently proposed an overhaul of Medicare’s largest accountable care organization (ACO) program, transforming it from the Medicare Shared Savings Program (MSSP) to the Pathways to Success initiative. The redesigned MSSP program...

Medicare Spending Greater on Patients in Downside Risk MSSP ACOs

by Jacqueline LaPointe

Moving accountable care organizations (ACOs) to Medicare Shared Savings Program (MSSP) tracks with downside financial risk may not help the accountable care initiative generate savings, according to a new analysis from the Center for...

House Reps Want to Extend MSSP Track 1 ACO Participation

by Jacqueline LaPointe

Seven House Representatives are calling on CMS to allow successful accountable care organizations (ACOs) in the Medicare Shared Savings Program’s (MSSP) Track 1 to continue in the upside-only financial risk track for a third...

71% of MSSP ACOs Likely to Quit Rather Than Assume Downside Risk

by Jacqueline LaPointe

The Medicare Shared Savings Program (MSSP) is requiring the 82 accountable care organizations (ACOs) that started in upside-only financial risk tracks in 2012 or 2013 to take on downside financial risk by 2019. However, the majority of...

MSSP ACOs Fell $2B Short of CBO’s Medicare Spending Estimate

by Jacqueline LaPointe

A new analysis from Avalere showed that Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) failed to reduce Medicare spending as the Congressional Budget Office (CBO) projected in 2010. The CBO estimated...

A Holistic View of the Patient Enables Risk-Based ACO Success

by Jacqueline LaPointe

Giving providers a holistic view of the patient resulted in accountable care organization (ACO) success for a risk-based organization in southern Florida, which earned a place on the list of ACOs achieving the greatest shared savings in...

Orgs Push for MSSP Track 1 Extension for Non-Risk-Bearing ACOs

by Jacqueline LaPointe

Six healthcare industry groups are urging CMS to extend participation in the Medicare Shared Savings Program (MSSP) Track 1 beyond two agreement periods to allow accountable care organizations (ACOs) more time to assume downside financial...

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