Tag Archives: beneficiary incentives

ACOs have more flexibility to establish beneficiary incentives under Pathways to Success

In August, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that will significantly change the Medicare Shared Savings Program (MSSP) if enacted. The proposed rule, known as “Pathways to Success,” provides new flexibilities for accountable care organizations (ACOs) to offer monetary beneficiary incentive programs. Beginning as early as July 2019, CMS proposes to allow certain MSSP ACOs to provide general monetary incentive payments to beneficiaries who receive primary care services in order to foster greater patient engagement.

In this paper, Milliman’s Carol Bazell, Susan Philip, and Laurie Lingefelt discuss key elements related to beneficiary incentives proposed under Pathways to Success. This paper is the fifth in a series of Milliman papers on the proposed rule.