CMS announced a “new direction” for the Medicare Shared Savings Program (MSSP) dubbed “Pathways to Success.” The changes will redesign participation options in hopes of encouraging accountable care organisations to take on risk quicker. CMS said ACOs taking on more risk can lead to more savings for the Medicare Trust Funds. The change also includes new tools and flexibilities in the Bipartisan Budget Act of 2018, including new beneficiary incentives, telehealth services and beneficiary assignment methodology choices.

MSSP includes 561 Accountable care organizations and serves more than 10.5 million Medicare beneficiaries.

CMS data credited MSSP saving a net $314 million to the Medicare Trust Fund in 2017. CMS now wants providers to take on more risk. However, CMS faces an industry not keen on the downside of value-based contracting. In fact, a recent study found that nearly three-fourths of ACOs would leave MSSP if forced to take on risk the following year.

What’s more, taking on more risk doesn’t guarantee an accountable care organization’s success. Nevertheless, CMS is hoping to push ACOs to take on financial risk arrangements sooner. Currently, more than eight out of every 10 MSSP ACOs are in Track 1. Track 1 lets ACOs keep half of the program’s savings without taking on any risk.
CMS wants to accelerate that number, so accountable care organizations face more risk starting on July 1, 2019. The plan calls for cutting the time ACOs can avoid risk in MSSP. Pathways to Success will reduce the risk from six years to two years for new ACO participants and three years for new, low-revenue ACOs.

In an attempt to tempt more ACOs to move away from non-risk tracks, Pathways to Success will offer more rewards for agreeing to task on risk.
Healthcare organizations have spoken out about the proposal in the past. Nine organizations sent a letter to CMS Administrator Seema Verma in September to voice concerns about proposed changes.