ACO Risk Mitigation Strategies: Part 1
Wakely’s new white paper, Rethinking Downside Risk: The Role of Stop Loss in ACO Contracts, helps accountable care organizations (ACOs), provider groups, and value-based care leaders evaluate how to manage downside risk in Medicare Shared Savings Program (MSSP) and CMS Innovation Center LEAD Model contracts. The first installment in Wakely’s ACO Risk Mitigation Strategies series, developed with Josh Gottesman of Brown & Brown, explains how aggregate stop loss, member-level stop loss reinsurance, and disciplined actuarial projection can help ACOs cap repayment exposure, support CMS financial guarantee requirements, protect the balance sheet, and retain more shared savings instead of giving away upside to an enabler or aggregator. For organizations preparing for two-sided risk, the paper offers practical guidance on quantifying repayment risk, comparing stop loss structures across MSSP and LEAD, and aligning actuarial analysis with broker market strategy.
