The Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) is offered to healthcare providers as “an opportunity to create a new type of health care entity, an Accountable Care Organization (ACO).” The program is voluntary and is designed to enable “providers to come together as an ACO to give coordinated, high quality care to their Medicare patients.” MSSP offers several tracks for ACOs to “assume various levels of risk” with the potential to share in the cost savings.
CMS recently released data for 472 ACOs participating in MSSP and caring for 9 million beneficiaries in 2017. Generally, the results were positive. More than half of the ACOs saved money and a third earned sharing savings. Both figures were increases from the 2016 participation results.
The National Association of ACOs (NAACO) released a summary of key data points found in the CMS MSSP report:
- $1.1 billion in gross savings
- Gross savings were generated by 60 percent of ACOs
- $800 million in shared savings bonuses paid to ACOs
- 34 percent of ACOs earned shared savings bonuses
- $314 million in net savings to Medicare (after accounting for bonuses paid to ACOs)
- A mean quality score of 90.5 percent for ACOs under pay-for-performance measurement
The net savings to Medicare of $314 million consisted of $291 million from those ACOs participating in Shared Savings only (Track 1) and $23 million from those ACOs participating in Shared Savings/Losses (Track 2 and 3).
While the results were positive for ACOs for 2017, new CMS proposals may “deter new entrants to the Medicare ACO program,” according to NAACO. While ACOs now have up to six years to prepare for taking financial risks while in the MSSP, a proposed rule would shorten the time in a shared savings only model to two years. In addition, CMS has proposed cutting the amount of shared savings in half, from 50 percent to 25 percent for shared savings only ACOs.