Why accurate claims coding for MSSP ACOs has become increasingly important

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By Jonah Broulette, Noah Champagne, Kathryn V. Fitch | 26 June 2018
The Centers for Medicare and Medicaid Services changed the benchmark methodology for affordable care organizations (ACOs) entering a renewal Medicare Shared Savings Program (MSSP) agreement period in 2017 and thereafter. The 2017 methodology introduced a regional adjustment. This brief explains how benchmark year 3 risk scores affect the benchmark calculation for MSSP renewals, presents an overview of the prior and new MSSP benchmark calculations, and illustrates how the change can affect an ACO’s benchmark under various scenarios.