Shared Savings and Losses | MidpageShared Savings and Losses
425.600Selection of risk model.425.601Establishing, adjusting, and updating the benchmark for agreement periods beginning on or after July 1, 2019, and before January 1, 2024.425.602Establishing, adjusting, and updating the benchmark for an ACO's first agreement period beginning on or before January 1, 2018.425.603Resetting, adjusting, and updating the benchmark for a subsequent agreement period beginning on or before January 1, 2019.425.604Calculation of savings under the one-sided model.425.605Calculation of shared savings and losses under the BASIC track.425.606Calculation of shared savings and losses under Track 2.425.609Determining performance for 6-month performance years during CY 2019.425.611Adjustments to Shared Savings Program calculations to address the COVID-19 pandemic.425.612Waivers of payment rules or other Medicare requirements.425.613Telehealth services.425.614-425.629[Reserved]425.630Option to receive advance investment payments.425.631-425.639[Reserved]425.640Option to receive prepaid shared savings.425.641-425.649[Reserved]425.650Benchmarking methodology.425.652Establishing, adjusting, and updating the benchmark for agreement periods beginning on January 1, 2024, and in subsequent years.425.654Calculating county expenditures and regional expenditures.425.655Calculating the regional risk score growth cap adjustment factor.425.656Calculating the regional adjustment to the historical benchmark.425.658Calculating the prior savings adjustment to the historical benchmark.425.659Calculating risk scores used in Shared Savings Program benchmark calculations.425.660Accountable Care Prospective Trend (ACPT).425.663-425.669[Reserved]425.670Adjustments to mitigate the impact of significant, anomalous, and highly suspect billing activity on Shared Savings Program financial calculations involving calendar year 2023.425.672Adjustments to mitigate the impact of significant, anomalous, and highly suspect billing activity on Shared Savings Program financial calculations involving calendar year 2024 or subsequent calendar years.425.674Accounting for the impact of improper payments on Shared Savings Program financial calculations.