ACO Programs Save Medicare More than $800M, Data Show

Sixty-four of the 243 Medicare accountable care organizations that launched in 2012 have saved enough to earn bonuses, according to financial performance results released by CMS on Tuesday (Rau, "Capsules," Kaiser Health News, 9/16).

The results are from two ACO programs that began in 2012: the Medicare Shared Savings Program and the CMS Innovation Center's Pioneer ACO program (Evans, Modern Healthcare, 9/16). Since 2012, more than 100 additional organizations have become Medicare ACOs (CMS release, 9/16).

ACOs Largely Achieve Savings Goals

Altogether, the ACOs have reduced Medicare spending by $817 million (Modern Healthcare, 9/16). The 64 ACOs received a combined $445 million in bonuses, while Medicare saved the remaining $372 million.

Meanwhile, four ACOs significantly overspent and now owe money to Medicare ("Capsules," Kaiser Health News, 9/16).

Pioneer ACOs

During their second performance year, the 23 Pioneer ACOs saved Medicare an estimated $96 million, and 11 of them qualified for shared savings payments of $68 million. The organizations reported lower per capita spending growth than Medicare fee-for-service.

Three Pioneer ACOs generated shared losses, and three chose to defer reconciliation until the end of the third performance year.

Meanwhile, the mean quality score for Pioneer ACOs also improved by 19%, increasing from a mean quality score of 71.8% in 2012 to 85.2% in 2013.

Further, the ACOs improved in 28 of 33 quality measures, which included screening for tobacco use and cessation and controlling high blood pressure. They also increased their average performance score for patient and caregiver experience in six of seven measures (CMS release, 9/16). 

The results come amid questions about the viability of the Pioneer ACO program, which has lost 10 of its 32 original participants (Viebeck, The Hill, 9/16).

MSSP ACOs

The new report covers two cohorts of MSSP ACOs: the first announced in April and the second in July. There were 204 MSSP ACOs with available data (Modern Healthcare, 9/16).

During their first year, 53 MSSP ACOs with available data held spending $652 million below their targets and earned performance bonuses of more than $300 million (CMS release, 9/16).

Meanwhile, 41 MSSP ACOs overspent. One MSSP participant will have to repay Medicare $4 million because it cost the agency $10 million more than estimated ("Capsules," Kaiser Health News, 9/16).

As part of its data release on Tuesday, CMS published the specific financial results of each of the MSSP ACOs (Modern Healthcare, 9/16).

In addition, the report found that MSSP ACOs improved on 30 of 33 quality measures, including measures like ratings of physician communication and screening for tobacco use. They also scored higher average performance rates on 17 of 22 Group Practice Reporting Option Web Interface measures (CMS release, 9/16).