Editor’s Note: This article was originally published in the Advisory Board Company’s General Counsel Agenda September 2015 issue.
This past spring Congress passed two pieces of legislation which provide significant payment incentives for providers who participate in the Medicare Shared Savings Program (MSSP) and other CMS, CMMI and commercial value-based payment models. The two laws—the ACO Final Rule and the Medicare Access and Chips Reauthorization Act (commonly referred to as the “SGR Fix”)—represent major steps toward CMS achieving its stated goal of having 30% of Medicare FFS payments tied to value and quality by the end of 2016, and 50% by the end of 2018. Together, the Final Rule and SGR Fix may provide the impetus needed for providers who have thus far been undecided about joining an ACO to take the plunge.
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