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The CMS on Friday finalized a rule that overhauls the Medicare Shared Savings Program, requiring accountable care organizations to take on risk sooner or be booted out of the program.
Under the redesigned program, which will take effect July 1, 2019, ACOs can choose to participate in one of two tracks: basic or enhanced. The basic track, which has a five-year performance period, only allows ACOs entering the program to be in a one-sided risk contract for two or three years depending on their revenue. For ACOs previously in the program, they can only be in a one-sided risk model for one year. In subsequent years of the basic track, ACOs will be forced to enter contracts with “progressively higher risk,” according to the CMS. The enhanced track is based on Track 3 of the Medicare ACO program, which is the most advanced track with the most downside risk.