On May 1, 2017, the Centers for Medicare and Medicaid Services (CMS) opened the application period for Accountable Care Organizations (ACOs) seeking to participate in the Medicare Shared Saving Program Year 2018. An ACO is comprised of groups of health care providers and other health care professionals who work together to manage and coordinate care for Medicare beneficiaries. As of January 1, 2017, there were 480 ACOs participating in the program serving over 9 million Medicare beneficiaries in all 50 states, the District of Columbia, and Puerto Rico.
ACO applicants can participate under one of the following Shared Savings Program tracks:
- Track 1: One-sided model; ACO’s share in savings but no losses
- Track 1 + CMS Innovation Center Model: (new for 2018 eligible Track 1 ACOs); Two-sided model; ACO’s share in savings and losses
- Track 2: Two-sided model; ACO’s share in savings and losses
- Track 3: Two-sided model; ACO’s share in savings and losses
Track 2, Track 3, and Track 1 + Model of the Shared Savings Program are all considered Advanced APMs in the Quality Payment Program. Track 1 does not meet the Advanced APM criteria and Eligible Clinicians (ECs) in Track 1 ACOs will be assessed under the Merit-based Incentive Payment System (MIPS) using the APM scoring standard. ECs who meet the Qualifying APM Participant threshold and participate in an Advanced APM will be excluded from MIPS, receive a 5% lump sum bonus, and receive a higher Physician Fee Schedule update starting in 2026.
Visit the CMS website to learn more about the Medicare Shared Savings Program and find out how to prepare to apply for the January 1, 2018, program start date.