In January, HHS Secretary Sylvia Burwell announced that HHS is accelerating Medicare’s transition to “alternative payment models.” HHS’s goal is to shift 30 percent of all Medicare provider payments to alternative payment models by 2016 and for 50 percent of all Medicare payments to be in alternative payment models by 2018. These goals, according to HHS, will be achieved through the Medicare Shared Savings Program (“MSSP”) ACOs and other alternative payment models.
This enhanced emphasis on MSSP ACOs, combined with HHS’s ambitiously short timeline for transitioning Medicare payments, will present special challenges and opportunities for health care providers currently affiliated with MSSP ACOs. In addition, this rapid movement of Medicare dollars to MSSP ACOs will no doubt prompt many health care providers to contemplate some role with an MSSP ACO for the first time.
For health care providers just now giving serious consideration to MSSP ACOs and even health care providers already deeply involved with MSSP ACOs, the requirement of exclusivity within MSSP ACOs may be confusing and concerning. This article summarizes the exclusivity requirement and provides an overview of possible alternatives.
To read the full article, click here. If you have any questions or would like additional information on this topic, please contact Tim Kennedy at (317) 977-1436 or tkennedy@hallrender.com or your regular Hall Render attorney.
