Preparing for downside risk through a participant-funded risk pool

  • Published on:
  • August 26, 2020

Provider: Physician Organization of Michigan Accountable Care Organization (POM ACO) ​

Background: Physician Organization of Michigan Accountable Care Organization (POM ACO) formed specifically to participate in the Medicare Shared Savings Program (MSSP) in 2013 as a Track 1 ACO. Track 1 is an upside-only track, so the ACO was eligible for shared savings every year but not responsible for repaying losses. At the start of their second agreement period, POM ACO began preparation for the end of their statutorily allowed time in an upside only arrangement, contemplating participation in the newly announced Track 1+, intended to gradually introduce providers to riskbearing arrangements. To prepare, the organization set about funding a risk pool, to protect it in the event that the organization ever became responsible for shared losses. To fund this pool, POM ACO began collecting annual membership fees among its participating organizations, which included independent physicians and physician groups.