ACOs: Heads Up: CMS Is Changing the Way Medicare Pays ACOs Under The MSSP

Why This Topic Matters

The rule affects how ACO performance is measured and compared, which can influence participation strategy, financial exposure, and readiness for broader Medicare payment reforms. It is relevant to organizations trying to understand evolving CMS policy and the shift toward regional and quality-based evaluation.

Article Sections

1. Background and CMS policy update

   Introduces the CMS final rule and places it in the context of ACO participation in Medicare payment reform. Summarizes the broader policy direction and the organizations involved.

2. Expect the bar to get lower

   Describes changes to performance measurement and benchmark setting for ACOs after the initial agreement period. Covers the role of historical and regional data in the updated methodology.

3. Prepare to compete on a county level

   Explains the move toward region-based comparisons and the related implications for how performance is assessed across different areas. Also notes the revised participation timeline for organizations entering risk-based tracks.

4. Watch for more specifics on service areas

   Summarizes CMS’s plans for defining regional service areas and sharing supporting county-level information. Includes references to where readers can find the rule and related public materials.