On December 21st, 2018, CMS released the final rule for the Medicare Shared Savings Program re-design, Pathways to Success. The new program is structured to encourage ACOs to move into increasingly significant risk arrangements with CMS over the 5 year agreement period.
Our physician leaders and operations team have worked together over the past 6+ months to formulate a plan for not just surviving, but thriving in this new risk environment. In April, the Augusta Health and Augusta Care Partners Boards voted to enter into the Pathways to Success program for 2020 in the Basic Track at Level B (see graphic below). This means that the network will have one additional year with no downside risk (2020) before moving into a downside risk arrangement that would earn all ACO participants the “Advanced Alternative Payment Model” 5% lump sum bonus on their Medicare Part B claims.
We understand that the program is complex and our participating practices will have questions about risk sharing, tactics to be successful in the program, and what it all means for providers. We will be reaching out to schedule one-on-one meetings with practices over the next few weeks to discuss 2020 participation, so please keep an eye out for scheduling communications from our Operations Manager, Mary Arrowood. In the meantime, please feel free to contact her with any questions at 540-245-7570 or firstname.lastname@example.org.