Webinar: Optimizing PY2025 Early Renewal, Track and Participant Selection

This webinar covers the newest multimillion dollar decision: Whether to early renew to take advantage of the MSSP methodology changes defined in the 2023 and 2024 Medicare Physician Fee Schedule (MPFS23 and MPFS24), rebase your benchmark years, and eliminate the CMS HCC v24-v28 model version skew. We review tactics to counter aggressive participant recruitment due to growth in M&A activity and multi-ACO aggregators and related considerations for determining the optimal ACO structure for participant changes. Finally, we illustrate the expected impact of the new “Step 3” claims beneficiary attribution methodology on ACO financials.

Clarification to live question “Would prospective assignment trump ACO REACH?”

No, a beneficiary assigned to a REACH ACO is generally excluded from assignment to the MSSP ACO regardless of if the MSSP ACO is under prospective or retrospective assignment. However, the MSSP ACO can use Medicare.gov voluntary assignment to block REACH voluntary assignment with the most recent voluntary assignment winning the beneficiary even if MSSP. Note that beneficiaries are considered assignable to the ACO regardless of if they’re aligned to a REACH ACO via claims or voluntary alignment and thus are included in all regional calculations for MSSP.

AGENDA

1. ACO structure

  • Participant retention in light of aggressive recruitment from growth in M&A activity and multi-ACO aggregators
  • Designing optimal ACO structure for participant changes: bifurcation, merging and multi-track strategy

2. Early renewal under MPFS23/24

  • Incorporating new rules on prior savings adjustment, prospective regional adjustment, risk ratio capping, regional capping, and rebasing to exclude COVID years
  • Impact of CMS HCC v24-v28 model version skew and new HCC risk capping methodImpact of new “Step 3” claims-based beneficiary attribution methodology

3. Annual selections

  • Method for making optimal selections for model, track, MSR/MLR, and prospective/retrospective assignment methodology

4. Calendar

  • Suggested 6-month calendar of decisions (Mar-Aug 2024)

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