What the CMS data on the Medicare Shared Savings Program tells us about ACOs

What the CMS data on the Medicare Shared Savings Program tells us about ACOs

The Centers for Medicare & Medicaid Services (CMS), as part of their move toward value-based care, established a program called the Medicare Share Savings Program (MSSP) as a way to encourage physicians to provide quality care at a lower cost. The cost savings would then be shared between Medicare and the physician. CMS recently released data on the MSSP, in particular as it relates to Accountable Care Organizations.

Accountable Care Organizations (ACOs) are “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.” ACOs who participate in the shared savings program agree to do so for a period of three years. This long-term commitment is reflected in much of the data released for 2016.

Farzad Mostashari, MD, writes in The American Journal of Managed Care (AJMC) that one of the most important findings in the released data is that “population health driven savings take time.” Dr. Mostashari points specifically to the following results:

  • The 100 “Freshman” ACOs that started in 2016 in aggregate had spending only $5 million below their benchmark and only 18% earned savings
  • The 85 Sophomores saved $50 million
  • The 100 Juniors saved $93 million
  • The 74 Seniors that started in 2013 saved Medicare $204 million
  • Those 74 Seniors are the ones that remain out of the 106 ACOs that started in the MSSP in 2013

Moving from fee-for-service to value-based care takes time and effort. ACOs have been found to be successful both in the area of quality care as well as in cost savings for their practices and for Medicare. As Dr. Mostashari points out, the 2016 Medicare data “should provide reassurance to policy makers and the public that it is possible to achieve both better care and lower cost.”