CMS’ 2025 Physician Fee Schedule proposed rule contains a provision that would establish a new “prepaid shared savings” option for Medicare Shared Savings Program (MSSP) participants. This would allow ACOs with a history of generating savings to make greater investments in services, improving care coordination, hiring staff, and building out health care infrastructure.
This proposed policy dovetails with the Advance Investment Payment (AIP) component of CMS’ ACO Primary Care FLEX payment model demonstration. The AIP includes a one-time, $250,000 advance payment to help cover some of the costs of forming an ACO when appropriate, as well as administrative costs associated with the model. This can include investments in new technology for more robust data collection and analysis.
The proposed rule and ACO Flex aim to use similar methods to address two different issues, according to Anna Basevich, Senior Vice President of Enterprise Partnerships and Customer Enablement at Arcadia. Basevich breaks down CMS' Advance Payment Policies, the challenges they aim to solve, and what they mean for the bottom lines of ACOs in a recent Palliative Care News article.