CMS Data Show Mixed Results From Medicare ACO Programs
On Thursday, CMS announced that providers participating in its Medicare accountable care organization programs -- created under the Affordable Care Act -- saved a total of $380 million in the first year, USA Today reports (Kennedy, USA Today, 1/30).
As part of its progress report on Medicare accountable care efforts, CMS released interim financial data from the first year of the Medicare Shared Savings Program -- an ACO initiative that launched in 2012 -- and in-depth savings analysis for its Pioneer ACO program (Evans, Modern Healthcare, 1/30).
Specifically, the data showed that 54 of the 114 MSSP participants had lower than projected expenditures in their first 12 months. Twenty-nine of those ACOs saved enough to generate bonus payments, which totaled $126 million. In addition, the ACOs generated $128 million in net savings for Medicare's trust fund (Gold, "Capsules," Kaiser Health News, 1/31).
Participants in the program also must meet quality performance targets. In the first year, the participating ACOs were required to report quality data, but they did not have to meet quality performance targets.
According to Modern Healthcare, five ACOs withheld their quality data. Two of those will not receive bonus payments, even though they qualified to share in the savings they achieved.
Pioneer ACO Results
Meanwhile, an independent preliminary assessment of the Pioneer ACO Program showed nine of the 32 organizations exited the program after the first year (Modern Healthcare, 1/30).
Of the remaining 23 organizations, nine had significantly reduced spending growth, generating $147 million in total savings in their first year while maintaining high-quality care ("Capsules," Kaiser Health News, 1/30).
Physician Group Results
CMS also released data from the Physician Group Practice demonstration. It found that seven out of 10 doctor practices participating in the program met benchmarks for improving quality and cost efficiency, generating $108 million in overall savings over five years (HHS release, 1/30).
New Bundled-Payment Participants
CMS on Thursday also announced that 232 acute-care hospitals, home health agencies, long-term care hospitals, physician practices and skilled-nursing homes have formally joined its Bundled Payments for Care Initiative (Modern Healthcare, 1/30).
CMS officials touted the data as a sign of improvement.
Jonathan Blum, CMS' principal deputy administrator, said, "We are even more pleased that the quality scores are improving."
Patrick Conway, the chief medical officer for Medicare, said, "On 15 out of 15 quality measures, [ACOs] did better than national benchmarks, as well as on four out of four patient satisfaction benchmarks."
However, both Blum and Conway acknowledged that not all of the ACOs saved money, noting that the organizations are fairly new and that ACOs are a "long-term" measure to achieve Medicare savings (USA Today, 1/30).
Meanwhile, David Muhlestein of Leavitt Partners said the results are "not what you'd consider a huge success." He noted that the data offer little incentive for providers who are on the fence about joining an ACO. He said, "They're on the diving board and watching, and this isn't going to convince them to jump any sooner" ("Capsules," Kaiser Health News, 1/30).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.