ACOs could get $250,000 upfront payment under new MSSP option

The Centers for Medicare & Medicaid Services (CMS) will soon take applications for a new payment model in the Medicare Shared Savings Program (MSSP). The new option, Advance Investment Payments (AIP), will begin in 2024 and is intended to increase MSSP participation by physicians and clinicians in rural and underserved areas who come together to form an Accountable Care Organization (ACO).

ACOs may apply for the AIP if they are new to the MSSP, considered a low-revenue ACO, inexperienced with performance-based risk, and participating in the Basic track. The AIP offers eligible ACOs a one-time upfront payment of $250,000 plus risk-adjusted per member, per month quarterly payments for up to two years. The payments are intended to help build infrastructure and promote health equity by meeting patients’ clinical and social needs. The advanced payments will be recouped from ACOs' shared savings in current and future years.

Eligible ACOs must complete a supplemental application for the AIP in addition to their MSSP application. They can submit applications through the MSSP Application Portal from May 18 to June 15 this year for the 2024 performance year. Questions may be directed to SharedSavingsProgram@cms.hhs.gov.

Additional information can be found on the MSSP Application Types and Timeline webpage and in the following resources:

• MSSP AIP Guidance document
• CMS MSSP Advance Investment Payments At-a-Glance
• CMS MSSP How to Complete AIP Supplemental Information and Spend Plan in ACO-Management System
• CMS MSSP Application Toolkit

For a detailed overview of all actions and deadlines available throughout the cycle, see the CMS MSSP Key Application Actions and Deadlines. To learn more about the application process, register for the upcoming office hours webinar hosted by CMS on May 8.

— Kate Freeman, AAFP Manager of Market Transformation

Posted on April 20, 2023