Salt Lake City, January 10, 2019 –Today, Leavitt Partners released “Pathways to Success: Options for ACOs,” a white paper that reports on predictions of the options available to current Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) under the recently finalized Pathways to Success rule.
Under the Pathways rule, ACOs will be designated either high or low revenue, based on claims data and practice revenues. This revenue determination will directly affect how quickly ACOs must take on downside risk. However, under the final rule, ACOs’ revenue status will not be known at the time they apply formally for the program.
Leavitt Partners’ research team used public and proprietary data sources to predict revenue status for 550 of the 560 currently active MSSP ACOs. The results show that 67% of current ACOs could potentially be designated high revenue. Furthermore, the study finds that individual ACOs cannot rely solely on characteristics like hospital leadership or ACO size to predict their revenue designation, as ACOs of all types were present in both the high and low revenue categories. It is unlikely individual ACOs will be able to fully understand the options that will be available to them under the Pathways program unless they conduct further analysis.
According to David Muhlestein, Chief Research Officer for Leavitt Partners, “As ACOs consider entering the MSSP under the new Pathways rule, they must recognize the strong possibility that they will end up being designated high revenue under Pathways and be required to assume downside risk more quickly. Careful analysis will allow ACO leaders to understand their situation and respond accordingly.”
ACOs interested in applying for new agreement periods under the Pathways program with a July 1, 2019 start date are required to submit non-binding letters of intent to apply by January 18. The application period opens shortly thereafter and will close in mid-to-late February.
The white paper can be viewed here.
About Leavitt Partners:
Leavitt Partners is a health care intelligence business. The firm helps clients successfully navigate the evolving role of value in health care by informing, advising, and convening industry leaders on value market analytics, alternative payment models, federal strategies, insurance market insights, and alliances. Through its family of businesses, the firm provides investment support, data and analytics, member-based alliances, and direct services to clients to support decision-making strategies in the value economy. For more information please visit www.LeavittPartners.com.