CMS Issues MSSP ACO Policy Changes in New Interim Final Rule

On April 30, the Centers for Medicare and Medicaid Services (CMS) released a second Interim Final Rule and additional waivers related to Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP). For ACOs in two-sided risk arrangements, shared losses will be mitigated based on the length of the public health emergency (PHE). If the PHE covers the full year, ACOs will not share any losses. ACOs that do not complete quality reporting will receive the ACO quality performance mean, while ACOs that do will receive the higher of their score or the mean.

CMS is also amending the MSSP timeline in light of the pandemic. The 2021 application cycle has been canceled, however, ACOs whose current agreements are set to expire at the end of 2020 will be allowed to extend those agreements through 2021. Similarly, CMS will offer BASIC track ACOs the option to forgo automatic advancement on the glide path to higher levels of risk and reward. These ACOs will then advance two levels in 2022.

CMS is also proposing adjustments to the financial methodology used to calculate ACO payments. All Parts A and B payment amounts made during an episode of care that includes the treatment of COVID-19 will be excluded from the determination of benchmark year and performance year expenditures.

Information about the program can be found on the CMS MSSP website. And additional information CMS’s response to the COVID-19 pandemic can be found on the CMS Current Emergencies website.



For more information visit the McDermottPlus Payment Innovation Resource Center or contact Mara McDermott at 202-204-1462 or