Listen now (31 mins) | Listen Now Currently, CMS is accepting public comment on a proposed Medicare Shared Savings Program (MSSP), known more commonly as the Accountable Care Organization (ACO) program, rule. The MSSP, created under the 2010 Affordable Care Act, is Medicare's flagship pay or performance program currently providing care to over 10 million Medicare beneficiaries. MSSP or ACO performance, or to the extent the program has reduced Medicare spending growth, has been widely debated largely because CMS has failed to evaluate the program Under this administration the program has come under substantial criticism. The proposed rule, published this past August 17 in the Federal Register, is this administration's effort to improve the program's performance moreover by reducing the number of years an provider can participate in the program, from six years to two, without taking financial risk or participate in what are termed upside only contracts. The administration argues absent financial risk providers do not fully engage in practice reforms to reduce spending. This assumption is also widely debated. Absent other substantial payment innovations, the success of the MSSP or ACO program is vital to the Medicare program, now forcasted to go bankrupt in 2026.