CMS Pathways to Success is a new five-year program designed to bring greater value to patients while rewarding participating providers.
Effective January 1, 2020, the CMS Pathways to Success program will replace the former MSSP program and introduce a risk acceptance glide path to further encourage the delivery of high value and quality care to Medicare beneficiaries.
The program includes a five-year participation period where the shared savings upside opportunity remains fixed at a maximum of 10% of the ACO’s annual expenditures during years one through five. There is no downside risk for the first year. Downside risk begins in year two, limited to 1% of the ACOs annual expenditures. In year three, the downside risk increases to 2% followed by 4% in years four and five. Participants can make annual decisions to continue with the program.
Skilled Nursing Facility (SNF) 3-day Rule Waiver:
Waiver for Payment for Telehealth Services: