As described in section III.G.4.b.(2)(a) of this proposed rule, for performance year 2025 and subsequent performance years, we are proposing to require Shared Savings Program ACOs to report the APP Plus quality measure set as ( proposed in section IV.A.4.c.(3) of this proposed rule
Consistent with the prior savings adjustment scaling factor, 50 percent represents an appropriate multiplier in this context because it represents a middle ground between the maximum sharing rate of 75 percent under the ENHANCED track and the lower sharing rates available under the BASIC track
These beneficiaries are those who received at least one primary care service during the assignment window or applicable expanded window for assignment (as defined in 425.20) from a physician who is an ACO professional in the ACO and who is a primary care physician as defined under 425.20 or who has one of the primary specialty designations included in 425.402(c), a FQHC or RHC that is part of the ACO, or an ACO professional in the ACO whom the beneficiary designated as responsible for coordinating their overall care under 425.402(c)
For example, if we receive a submission for a MIPS performance category without any measure or activity data (for example, without numerator and denominator data for any quality measures, without a response of yes for any improvement activities, without a yes or no response for an attestation, or responses for the required objectives and associated measures and attestation statements for the Promoting Interoperability performance category), and the data submission includes only non-scorable data (such as the practice ID, measure ID and TIN/NPI information), we assign a zero score for the applicable MIPS performance category in the event we do not receive a subsequent submission with measure or activity data
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Archived from the original on March 5, 2020
