The Medicare Shared Savings Program (MSSP), launched by CMS in 2012, has facilitated ACO participation in risk-sharing payment arrangements for Medicare lives. Each ACO’s financial reimbursement is tied to performance against quality, cost, and experience of care based on the risk burden of its eligible Medicare population.

This guide is designed to be a foundational reference for Medicare risk adjustment within MSSP ACOs. In it, we’ll explore:

  • How risk adjustment works
  • The CMS HCC model used in MSSP
  • Key factors for ACO risk adjustment success
  • Evaluation criteria to help ACO risk adjustment programs improve over time
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