WHN Extends Current Performance Year
WellStar Health Network’s current Medicare Shared Savings Program Agreement was set to expire December 31, 2018. CMS’s proposed “Pathways to Success” outlined its intent to increase savings for the Medicare Trust Fund by requiring ACOs to transition to two-sided risk models (up and downside risk). To give ACOs more time to evaluate the new program, CMS provided the opportunity for ACOs like WHN, whose existing contract expired December 31, 2018, to extend the current contract terms and conditions for six months until June 30, 2019.

The WHN board approved extending the current participation agreement (upside only) in the MSSP through June 30, 2019. Notice of this decision was sent by email to all ACO participants on November 14, 2018. Based on the terms of your ACO Participation Agreement, your practice is not required to sign an amendment for this extension. While no decision has been made regarding MSSP participation beginning July 1, 2019, participation in the MSSP program through June 30, 2019 will qualify your practice for MIPS credit for certain reporting requirements for the full year of 2019.
Seema Verma

“Pathways to Success is a bold step toward quality healthcare at a lower cost through competition and beneficiary engagement. The rule strikes a balance between encouraging participation in the ACO program and advancing the transition to value, ultimately protecting taxpayers and patients. Medicare can no longer afford to support programs with weak incentives that do not deliver value. As we structure new payment arrangements, the impact on the overall market will be top of mind.”

Upon CMS’s release of the MSSP Final Rule, WellStar Health Network’s Board will evaluate the Pathways to Success program and communicate on further participation beyond June 30, 2019.