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CMS to ease Medicare ACOs into risk models in bid to boost participation

November 2, 2022Shannon MuchmoreHealthcare DiveTransitioning to VBC,Medicare, MA, MSSP, & Medicare ACOs,Physician Fee Schedule

The CMS is making changes to Medicare’s accountable care organization program in an effort to jumpstart participation that has recently plateaued, the agency said in its final 2023 Physician Fee Services payment rule released Tuesday.

Beginning in January 2024, ACOs that don’t have experience with performance-based risk will be able to stay in a one-sided risk arrangement for up to seven years before transitioning to two-sided risk.

With one-sided risk, the ACO can share in savings but does not have to take losses as they do in two-sided risk.

Also, ACOs new to the program will get a one-time payment of $250,000 and quarterly payments for the first two years of participation.

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