
Medicare Shared Savings Program
Mercy participates in the Medicare Shared Savings Program as Mercy Health ACO, LLC. ACOs are organizations formed by groups of doctors and other health care providers that pledge to high quality, patient-centered, coordinated care for patients covered by Medicare.
ACO Criteria
ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe and timely. CMS has established quality measures on care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care.
Mercy Health ACO
Mercy is a highly integrated organization that includes hospital and outpatient services across Missouri, Oklahoma, Arkansas, and Kansas; as defined in communities by location: North Central (Springfield and Joplin/Kansas), East (St Louis, Washington, Jefferson, and Perry), West (Oklahoma), and South Central (Northwest Arkansas and Fort Smith). Mercy Health ACO is comprised of integrated physicians, critical access hospitals, and rural health clinics across the entire Ministry. These Mercy providers work together to achieve better care for individuals, better health for populations, and lower growth in health care expenditures.
Pursuant to authority granted by Congress, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of the Inspector General (“OIG”) have issued waivers that waive certain provisions of the federal fraud and abuse laws that may otherwise limit innovation by accountable care organizations participating in the Medicare Shared Savings Program (“MSSP”), including the ACO Participation Waiver. See 80 Fed. Reg. 66726 (Oct. 29, 2015). To receive the benefit of the ACO Participation Waiver, an accountable care organization must publicly disclose a description of the arrangements covered by the waiver. The description should not include any financial or economic terms. This disclosure is made pursuant to this public disclosure requirement.
Mercy Health ACO, LLC ("Mercy ACO") has utilized the ACO Participation Waiver to waive the federal Stark Law and the federal Anti-Kickback Statute with respect to the following arrangements involving the Mercy ACO, one or more of the participants or providers/suppliers of the Mercy ACO, or a combination thereof:
- The Board of Managers of the Mercy ACO ("ACO Board") has made bona fide determinations that the following arrangements are reasonably related to the purposes of the MSSP, as further described in this notice: Mercy Health and/or certain Mercy affiliates are participants in the Mercy ACO and physicians employed by the Mercy affiliates are providers/suppliers in the ACO. Under employment agreements entered between such Mercy affiliates and its employed physicians, the physicians agree to perform services for patients, including Medicare fee-for-service beneficiaries who have been attributed to the Mercy ACO under the rules of the MSSP, and the Mercy affiliates agree to compensate the physicians in accordance with a physician compensation plan adopted by Mercy Health (the “Plan”) for each fiscal year, with the most recent Plan having been adopted in June 2025. The Plan has been designed by Mercy Health to promote accountability for the quality, cost and overall care of patients by linking compensation to improved quality and care outcomes. The Plan also facilitates the management and coordination of care of patients through the Mercy ACO and encourages investment in infrastructure and redesigned care processes for high quality and efficient service delivery for patients. In summary, the Plan supports and promotes the goals and objectives of Mercy ACO’s participation in the MSSP. Accordingly, the ACO Board has made a bona fide determination, consistent with its fiduciary duty of loyalty to the Mercy ACO, that the Plan, and the compensation payable thereunder, is reasonably related to the purposes of the MSSP.
