Accountable care organizations (ACOs) were handed a big win in the 2023 Physician Fee Schedule (PFS) with several changes to the shared savings program that will likely encourage participation.
The Centers for Medicare and Medicaid Services (CMS) finalized changes to the Medicare Shared Savings Program, which is the nation’s largest ACO program that covers more than 11 million people with Medicare and includes more than 500,000 healthcare providers. ACOs, which are groups of healthcare providers that work together to coordinate care and lower costs, while also taking on positive and downside financial risks. ACOs have achieved big savings wins over the last several years, including saving CMS more than $4 billion in 2020 with more than 500 participating ACOs.
CMS said it is still finalizing proposals for new payments for new ACOs to use to support their participation in the program, including hiring additional staff or addressing social needs of people with Medicare. The agency is also finalizing a health equity adjustment to ACO scores, revising the benchmarking methodology and giving ACOs more time before being hit with downside risk.