How Did Medicare ACOs Perform in 2015?

Updated: Nov 5, 2018

On Thursday, August 25th, CMS released the performance data of Medicare ACOs in 2015 (link). The results show progress and a net savings of nearly half a billion dollars. We'd like to know more about how technology impacts performance in the new value-based care world.

Main Points:

- The 400+ Medicare ACOs generated $466 million in savings in 2015

- 125 ACOs qualified for shared savings rewards by meeting their quality standards and cost threshold

- ACOs that have been enrolled in the program longer had a better success rate at cutting costs.

Pioneer ACOs:

- The 12 Pioneer ACOs saw a 24% increase in the number of beneficiaries per ACO.

- The Pioneer ACOs generated $37 million in savings

- 8 Pioneer ACOs generated savings, while 6 of these ACOs earned shared savings.

- Out of the 4 Pioneer ACOs that generated losses, only 1 owed shared losses.

- All 12 Pioneer ACOs showed strong quality performance scores.

Medicare Shared Savings Program (MSSP) ACOs:

- These 392 MSSP ACOs generated $429 million in savings (inclusive of savings and losses)

- Only 119 (Approx. 30%) of these ACOs earned shared savings rewards.

- Out of the 392 ACOs, 83 (Approx. 21%) met their cost benchmark but not enough to qualify for any rewards.

- Nearly half of the MSSP ACOs did not generate any savings.

- ACOs with more experience in the program were more likely to earn savings rewards: 42% of ACOs that started in 2012 qualified for savings rewards in 2015 (compared to just 21% of those that joined the program in 2015)

However, there was no mention of technology's role in ACO performance. As we get closer to the start date for MACRA (January 1, 2017), information on the technology platforms and combinations to achieve cost cuttings and improve quality scores can benefit physicians trying to understand the new landscape. It's fantastic to hear that ACOs with more experience performed better. What can we learn from them? How can MACRA physician practices utilize EHRs and data analytics to succeed?

#Policy #CostAnalysis