Financial Benchmarking

Background
Setting a financial benchmark is a fundamental component of measuring ACO success and determining whether an ACO can share the savings it generates. ACO performance is measured using a multi-step process that evaluates an ACO’s effectiveness in lowering expenditures for a group of assigned beneficiaries against a financial benchmark reflective of the ACO’s historical costs. Benchmarks are initially established for new ACOs, updated during agreement periods and reset or rebased when ACOs enter subsequent agreement periods.

Overview

  • MSSP benchmarking methodology is outlined in this CMS resource
  • Next Generation ACO benchmarking methodology is explained in this CMS resource

News and Advocacy

  • NAACOS resource on the Effect of Medicare Classifications of ESRD Beneficiaries on ACO Expenditures

  • NAACOS Summary of Final MSSP Benchmarking Rule 

  • CMS releases Final MSSP Benchmarking Rule

  • NAACOS and Other Prominent Organizations Submit Comments to CMS on Regional Benchmarking NPRM 

  • NAACOS comments on HCPLAN Financial Benchmarking White Paper

  • NAACOS Benchmarking NPRM Summary  

  • NAACOS webinar walks through CMS Benchmarking NPRM 

  • CMS notice of proposed rulemaking (NPRM) (factsheet available here) puts forward proposed changes to the MSSP benchmarking methodology, among other MSSP changes.

  • The final 2015 CMS rules on Quality Measures and Benchmarking for the MSSP were published October 31, 2014. Read the text of the rule applicable to ACOs.

To read more about developments related to Financial Benchmarks and other key policy issues effecting ACOs, please visit our newsletter page. 

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