ACOs taking on risk performed better in Medicare program last year

By | October 3, 2019

Dive Brief:

  • Accountable Care Organizations in the Medicare Shared Savings Program (MSSP) generated nearly $ 740 million in savings last year, according to data recently released by CMS.
  • ACOs that took on downside risk performed better, reducing spending by an average of $ 96 per beneficiary compared to $ 68 for those that did not have more risk. Physician-led organizations also saved more ($ 180 per beneficiary) than those led by hospitals ($ 27 per beneficiary).
  • The groups maintained quality metrics last year as well, with 93% earning quality improvement reward points, the agency said.

Dive Insight:

The Medicare ACO program is frequently scrutinized for those studying the industry’s shift to value-based payment reform. It has shown some success, as have ACOs more broadly, but policymakers worry providers may drop out of the model if they face too many restrictions or uncertainties.

CMS overhauled MSSP in December with a push for more ACOs to take on downside risk, cutting the time participants had to ramp up to financial responsibility in the model. Last year, 548 ACOs reported results for the program.

About 200 ACOs began the revamped program in July and CMS is taking application for another start date of Jan. 1.

The agency is “closely monitoring” MSSP, CMS Administrator Seema Verma wrote Monday in a Health Affiars blog post touting the results. “We are excited to see growing interest, and we will continue to support health care providers on the front lines who are hard at work building new ways to deliver higher quality care at lower cost,” she said.

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The National Association of ACOs also promoted the latest data, saying ACOs are proving their sustainability.

“These numbers put to rest any notion that ACO savings are ‘modest’ and illustrate the strong performance of the leading Medicare alternative payment model,” the group’s CEO Clif Gaus said. “Given time, we know ACOs save money and provide benefit for patients and taxpayers.”

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