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The Medicare Shared Savings Program (MSSP) is the nation’s single largest initiative to move the US health care system from volume to value. In only six years, the MSSP has grown to include 561 participating accountable care organizations (ACOs) serving 10.5 million assigned beneficiaries – nearly one-third of traditional Medicare beneficiaries with Part A and Part B coverage.
Under the MSSP, ACOs serve a defined population of Medicare beneficiaries with an annual spending target called a “benchmark” and a series of quality thresholds. ACOs that spend less than the benchmark share the savings with the federal government. ACOs have delivered superior quality to Medicare patients and have achieved savings relative to their spending targets and to other health care providers that do not participate in the MSSP.
On August 9, the administration issued a proposed rule that makes significant changes to the MSSP. It is a complex rule with many technical policy changes, some of which would improve the stability and predictability of the program. But the central proposed policy change would dramatically accelerate the requirement that ACOs take on downside financial risk.