ACOs in the Pioneer ACO model and Medicare Shared Savings Programs (MSSP) generated more than $372 million in total program savings for Medicare ACOs, according to the CMS.
The news is drawn from preliminary quality and financial results from the second year of performance for 23 Pioneer ACOs, and final results from the first year of performance for 220 MSSP ACOs.
Their growth continues from last year, when ACOs outperformed published benchmarks for quality and patient experience, and improved significantly on almost all measures of quality and patient experience this year. Pioneer ACOs showed improvements in three key areas: financial, quality of care, and patient experience.
Key findings on Pioneer ACOs include the following:
- During their second performance year, Pioneer ACOs generated estimated total model savings of over $96 million and at the same time qualified for shared savings payments of $68 million. They saved the Medicare Trust Fund approximately $41 million.
- Pioneer ACOs achieved lower per capita growth in spending for the Medicare program at 1.4 percent, which is about 0.45 percent lower than Medicare fee-for-service.
- The organizations showed improvements in 28 of 33 quality measures and experienced average improvements of 14.8 percent across all quality measures. These measures included screening for future fall risk, screening for tobacco use and cessation, patient experience in health promotion and education, and controlling high blood pressure.
- The Pioneer ACOs improved the average performance score for patient and caregiver experience in six out of seven measures. These results suggest Medicare beneficiaries who obtain care from a provider participating in Pioneer ACOs report a positive patient and caregiver experience.
Key findings on MSSP results include the following:
- 53 MSSP ACOs held spending $652 million below their targets and earned performance payments of more than $300 million as their share of program savings.
- An additional 52 ACOs reduced health costs compared to their benchmark, but did not qualify for shared savings, as they did not meet the minimum savings threshold.
- SSP ACOs improved on 30 of 33 quality measures, including patients’ ratings of clinicians’ communication, beneficiaries’ rating of their doctor, health promotion and education, screening for tobacco use and cessation, and screening for high blood pressure.
- SSP ACOs achieved higher average performance rates on 17 of 22 Group Practice Reporting Option Web Interface measures reported by other Medicare FFS providers reporting through this system.
Source: CMS, September 16, 2014
Guide to Accountable Care Organizations lays the groundwork for an ACO program, delivering a comprehensive set of 2012 ACO benchmarks from 200 companies; a framework for clinical integration, a key ACO prerequisite that puts participating providers on the same performance and payment page, and much more.