The Medicare Shared Savings Program (MSSP) offers Medicare-enrolled providers the opportunity to work together and clinically integrate under the legal structure of an accountable care organization (ACO), for the purpose of reducing costs, improving clinical quality, and promoting population health.
The MSSP offers multiple participation tracks with differing levels of risk and reward. ACOs are required to meet certain quality standards to be eligible to earn a shared savings payment, if the ACO is able to reduce the growth in total cost of care. New Medicare ACOs can join the program in a risk-free (bonus-only) track, and remain there for seven years, before moving to a risk-bearing track.
Below are important upcoming application deadlines and details about the application process for applicants targeting a start date of January 1, 2025.
Background on ACOs
As ACOs, physicians, hospitals, and others involved in patient care are responsible for the total cost, clinical quality, and experience of an assigned Medicare fee-for-service (FFS) beneficiary population.
The MSSP is the largest ACO program in the country. In the 2024 performance year, the MSSP has 480 ACOs providing care for 10.8 million assigned beneficiaries. In the 2022 performance year, participating ACOs collectively earned shared savings payments of $2.5 billion and an average quality score of 81%.
Important Application Dates
The MSSP application period for the initial data submission is May 20, 2024–June 17, 2024, through the ACO Management System (ACO-MS). The application process will continue throughout the summer of 2024, with subsequent deadlines of August 1, 2024, to add participants and September 5, 2024, to withdraw participants.
Preparing to Apply
While preparing to apply, it’s important for new ACOs to consider key strategic and operational items, such as:
- Understanding of various tracks within the MSSP and corresponding benefits and requirements
- Assessment and determination of ACO participants
- Formation of the ACO legal entity and board
- Creation of legal contracts such as a Participation Agreement between the ACO and its participants
- How financial risks and rewards will be distributed
- Operational planning for data reporting, care management, and quality performance improvement activities
- How existing value-based care infrastructure, such as care management teams, can be leveraged or scaled for the Medicare FFS population
- Legal waivers and incentives that the ACO may wish to pursue, such as the three-day skilled nursing facility (SNF) rule waiver or beneficiary incentive payments, or others that the ACO’s board may create
We’re Here to Help
For support navigating the application process or if you have questions related to ACOs please reach out to your Moss Adams professional.
Additional Resources
Special thanks to Rachael Peterson, Health Care Consultant, for her contributions to this article.