CMS finalizes rules for Medicare Shared Savings Program ACOs

The Centers for Medicare & Medicaid Services is offering more flexibility for accountable care organizations in its Medicare Shared Savings Program, a move intended to keep and grow provider participation.

New rules released Thursday include a third track for providers to take on higher risk and to share in increased savings, according to CMS.

Over 400 healthcare facilities are voluntarily participating in the Medicare Shared Savings Program as Accountable Care Organizations, agreeing to take on the risk but also the savings of changing the delivery of care.

Early data last year showed successful results, according to CMS. During the program's first two years, ACOs hit 30 of 33 quality measures, CMS stated. Providers enrolled in the Pioneer ACO model achieved the greatest results.

[Also: See top ACOs in each benchmark]

The new rules released Thursday are based on successful components of the Pioneer ACO model. They are designed to help allay concerns of achieving even greater savings to hit benchmarks.

The benchmarks in the new rule provide strong incentives to improve patient care and generate cost savings, according to CMS. Further improvement to the benchmarking methodology is expected to be released later this year.

Data sharing between CMS and the ACOs is streamlined and organizations can more easily access data on their patients in a secure way, according to CMS.

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The voluntary Medicare Shared Savings Program was created in the Affordable Care Act to improve care and reduce costs. Continued growth is a key component.

The Department of Health and Human Services earlier this year gave a goal of 2016 for 30 percent of Medicare payments to be tied to quality and value through alternative payment models. By 2018, 50 percent of Medicare payments should be tied to value of care.

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In its first two years, the Pioneer Accountable Care Organization Model generated over $384 million in savings to Medicare while keeping a high quality of care, according to an independent evaluation recently released by CMS. This is a savings of about $300 per participating beneficiary per year.

CMS modified the proposed regulations in its new rule after getting comments from a December 2014 Notice of Proposed Rulemaking.

Here is the full text of the rule:

Twitter: @SusanMorseHFN