The Centers for Medicare & Medicaid Services today announced the creation of a Medicare Accountable Care Organization Track 1+ Model. The new model will qualify as an advanced alternative payment model under the Medicare Access and CHIP Reauthorization Act by incorporating more downside risk than is currently present in Track 1 of the Medicare Shared Savings Program, but less downside risk than is currently present in the more advanced Tracks 2 and 3 of the MSSP. It also will include prospective beneficiary assignment to allow ACOs to know in advance the patient population for which they are responsible; choice of symmetrical thresholds from which to start sharing in savings or losses; and the option to elect the skilled nursing facility Three-Day Rule Waiver to provide greater flexibility. The model will begin in 2018; CMS says more information is forthcoming. “We commend CMS for creating the Track 1+ ACO model,” said Tom Nickels, AHA executive vice president of government relations and public policy. “This new ACO model will allow hospitals and clinicians to partner to provide high-quality, cost-efficient care for patients without incurring the unsustainable financial risk that current ACO models require. We have recommended CMS better balance risk and reward for its ACO models, and based on the details in the CMS fact sheet, Track 1+ is a move in the right direction. We also are pleased that CMS is adding to the models available for participating clinicians to receive credit toward MACRA advance payment model incentives, as we urged.” AHA members will receive more information soon.

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