25 Things to Know About The CMS Medicare ACO Proposed Rule: Pathways to Success

Here are 25 major points to note in the CMS Pathways to Success Proposed Rule introduced on August 9th:

The redesigned Medicare Shared Savings program is called “Pathways to Success.
There are five stated goals Pathways to Success is intended to advance: Accountability, Competition, Engagement, Integrity, and Quality.
The CMS projected financial impact of the proposal would be savings to Medicare of $2.2 billion over ten years.
CMS notes that 460 of the 561 or 82% of all ACOs in the Shared Savings Program in 2018 – are not taking on risk for increases in costs.
The amount of time that an ACO can remain in the program with upside-only risk would be limited to two years (or one year for ACOs identified as having previously participated in MSSP under upside-only risk) instead of the current timetable of up to six years.