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MSSP Financial Benchmark Basics The financial benchmark is based on the ACO's costs for the three benchmark years prior to the start of each agreement period. Benchmark years 1, 2, and 3 are referred to as BY1, BY2, and BY3, respectively?with BY3 being the most recent year.
That's the primary goal of the Medicare Shared Savings Program (MSSP). The MSSP is an alternative payment model in which eligible providers, hospitals, and suppliers are rewarded for achieving better health for individuals, improving population health, and lowering growth in healthcare expenditures.
The shared savings rate is the percentage of any estimated savings (compared with benchmark) that is paid to the ACO, subject to meeting any requirements for quality performance. For example, an ACO with a savings rate of 50 percent that outperforms its benchmark by 3 percent would keep 1.5 percent of benchmark spend. The math of ACOs - McKinsey & Company mckinsey.com ? healthcare ? our-insights ? t... mckinsey.com ? healthcare ? our-insights ? t...
The BASIC track is separated into 5 levels, with levels A and B representing one-sided arrangements, and levels C, D, and E requiring increased levels of downside-risk.
(1) The term production payment means, in general, a right to a specified share of the production from mineral in place (if, as, and when produced), or the proceeds from such production. Such right must be an economic interest in such mineral in place. 26 CFR § 1.636-3 - Definitions. | US Law | LII / Legal Information Institute cornell.edu ? cfr ? text cornell.edu ? cfr ? text
Whereas MSSP uses the tried-and-true FFS payment model, ACO REACH provides more advanced alternative payment arrangements, such as capitation and preferred provider arrangements, and includes additional benefit enhancement. MSSPs also have more flexibility in how they structure their programs and how they provide care.
The MSSP assignment methodology has two phases. The first phase assigns beneficiaries based on primary care services from primary care physicians (PCPs). If a beneficiary is not assigned in the first phase, then the beneficiary can be assigned based on primary care services performed by certain specialists. Prospective and retrospective assignment in MSSP and beyond milliman.com ? milliman ? pdfs ? articles milliman.com ? milliman ? pdfs ? articles