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That is, about 5 percent of ACOs participating in performance year 2023 were estimated to benefit from the proposed HEBA policy at rebasing (median effect about 1 percent increase to the benchmark), because an ACO would receive the proposed HEBA only if the HEBA adjustment were higher than the existing higher of adjustment method (see discussion in section III.G.7.b of this proposed rule, and proposed 425.652(a)(8)(ii)(B)( 1 ) and 425.662(c))

[530] Specifically, we are proposing to adjust the following Shared Savings Program calculations, as applicable, to exclude all Medicare Parts A and B payment amounts associated with a HCPCS or CPT code on claims for the specified claim types displaying SAHS billing activity: Calculation of Medicare Parts A and B FFS expenditures for an ACO's assigned beneficiaries for all purposes including the following: Establishing, adjusting, updating, and resetting the ACO's historical benchmark and determining performance year expenditures

This is the same price proxy used for the Non-Health Staff Compensation cost category in the 2017-based FQHC market basket (85 FR 84708)

This course was published in the February 2019 issue and expires February 2022