The CY 2024 Medicare Physician Fee Schedule final rule introduces transformative changes for ACOs, ushering in new reporting requirements that demand strategic adaptation. ACOs must carefully navigate these modifications to ensure compliance and optimize their ability to deliver high-quality, coordinated care.

A principal shift is the establishment of a new Medicare Clinical Quality Measure collection type for ACOs and alignment of the Shared Savings Program with the MIPS Promoting Interoperability requirements from January 1, 2025. This integration of digital measurement into the reporting landscape emphasizes CMS' commitment to advancing healthcare quality. ACOs are urged to embrace technological solutions and refine their reporting mechanisms to meet this standard effectively.

Financial benchmarking methodologies undergo a significant transformation, impacting ACOs from January 1, 2024. The introduction of a cap on risk score growth in both regional service areas and assigned beneficiary populations aims to create a level playing field, specifically for those caring for medically complex, high-cost beneficiaries. ACOs should proactively reassess their financial strategies, accounting for these caps to ensure they can continue providing optimal care without incurring negative regional adjustments.

Beneficiary assignment methodologies are evolving to recognize the vital role of nurse practitioners, physician assistants, and clinical nurse specialists in primary care. Starting in the performance year beginning January 1, 2025, the expanded 24-month assignment window requires a comprehensive approach to patient population analysis. ACOs must adjust their reporting strategies to capture a more accurate representation of the beneficiaries under their care.

ACOs with participants falling under MIPS, a shift in reporting requirements mandates the inclusion of MIPS Promoting Interoperability performance category measures from January 1, 2025. Aligning with MIPS standards aims to streamline reporting, fostering interoperability. ACOs with MIPS participants must proactively integrate these measures into their reporting frameworks for seamless compliance.

While these changes present challenges, CMS has acknowledged potential burdens and offers exclusions and reporting options to alleviate the impact. This flexibility allows ACOs to navigate reporting requirements and collaborate with CBOs to advance health equity.

ACOs must proactively work to meet the changing reporting requirements in 2024. Partnering with MIPS-qualified registries, like Quantician, helps enhance reporting accuracy, ensuring compliance with CMS standards and positioning ACOs as leaders in delivering high-quality care.