Health Affairs April 23, 2019
In 2012, the Centers for Medicare and Medicaid Services (CMS) launched new voluntary payment models for Accountable Care Organizations (ACOs) with incentives to control spending. The number of Medicare ACOs has grown steadily to more than 600 organizations responsible for managing care for nearly 12 million Medicare beneficiaries in 2018. Similar programs have been established in the commercial, Medicare Advantage, and Medicaid markets. However, the majority of Medicare ACOs participate in Track 1 of the Medicare Shared Savings Program (MSSP) under a “one-sided” arrangement – also known as “upside-only” – where ACOs earn shared savings payments if their annual spending is below a target budget known as a benchmark, but are not required to repay Medicare if their spending exceeds...
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