Institute Response to 2023 MSSP Proposed Changes

Hello Institute Members and Friends,

As you may know, on July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS). This is an important step forward for value-based care, as specific changes are being proposed for the Medicare Shared Savings Program (MSSP) that, if finalized, represent some of the most significant reforms since the program was finalized in November 2011 and ACOs began participating in 2012.

Changes include the following:

  • Incorporating advance shared savings payments to certain new Medicare Shared Savings Program ACOs that could be used to address Medicare beneficiaries’ social needs. (This is one of the first times Traditional Medicare payments would be permitted for such uses, and is expected to be an opportunity for providers in rural and other underserved areas to make the investments needed to become an ACO and succeed in the program.)
  • Smaller ACOs will have more time to transition to downside risk, further helping to grow participation in rural and underserved communities.
  • health equity adjustment will be applied to an ACO’s quality performance category score to reward excellent care delivered to underserved populations.
  • Benchmark adjustments will be made to encourage more ACOs to participate and succeed, which would help achieve the goal of having all people with Traditional Medicare in an accountable care relationship with a healthcare provider by 2030.

I’m pleased to inform you that the Institute is acting on your behalf to make the most of this important occasion.

  1. First, we’re publishing an intelligence brief soon that will give you the details you need to know about the proposed changes, including implications and recommendations.
  2. Second, we are collecting feedback from members and partners to share with CMS.


Please provide your perspective on these proposed changes by completing this form. We’ll collect all of the feedback you submit and pass it along to CMS. You can submit feedback here.

This is a significant opportunity for our collective voice to amplify the changes needed to drive value and equity. Thank you in advance for your participation and contributions!

Best regards,
Eric Weaver