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As we explained in the proposed rule, this proposed policy is designed to be responsive to innovations in disease- and condition-specific models, will be applied narrowly, and will have a limited impact on beneficiaries that are voluntarily aligned to a Shared Savings Program ACO

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[PubMed: 12006410] 58

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In this proposed rule, to ensure budget neutrality for the proposed update to the MS-LTC-DRG classifications and relative weights prior to the application of the 10-percent cap (that is, uncapped relative weights), under 412.517(b), we are proposing to continue to use our established two-step budget neutrality methodology