The Centers for Medicare and Medicaid Services (CMS) proposed a new regulation for Medicare accountable care organizations that includes several changes to eligibility requirements, definitions of an ACO participant and how "pioneer" ACOs transition into the Affordable Care Act's Medicare Shared Savings Program.
Also of note is a proposal that Medicare ACOs share savings but not financial losses will get more time to transition to a two-sided risk model. The change, which would let ACOs experience one-sided risk for an additional three years, was included in a proposed rule released this afternoon. Current rules require that ACOs sharing savings can only continue in the program if they begin to share financial losses after their initial agreement period. An ACO's initial agreement period is three years. According to the new rule, CMS would allow ACOs to stay longer in the first model, but they would have a lower sharing rate to encourage them to take on more risk.
The 429-page rule is the first update to the program in three years. Comments are being accepted for 60 days. VNAA is currently analyzing the regulation and will update members.