The more than 400 accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) in 2016 generated $652 million in gross savings, with the majority coming from groups which have been in the program since 2012 or 2013.
In the results released on Oct. 27 by CMS, the ACOs that have been in MSSP since 2012 and 2013 accounted for $503 million in gross savings. The newer the participants, the less money they saved: ACOs that entered in 2014 saved $94 million, 2015 entrants saved $50 million and the 100 ACOs that entered MSSP in 2016 saved only $6 million.
The 2012 and 2013 ACOs received $351 million in shared savings payments, leaving the remaining $151 million as savings for CMS. That’s in contrast to 2015, when CMS spent $217 million more in awarding bonuses to ACOs in both the MSSP and Pioneer ACO programs than what participants were projected to have saved.
The HHS’s Office of the Inspector General had reached a similar conclusion about ACO experience equating to greater savings in a report released in August. The CMS report also found the successful ACOs do well on enhancing quality. Of the ACOs which have been in MSSP for at least two years, the average quality score was 93.7.
“These results show the growing success of ACOs, which is a positive trend that should not be ignored,” Clif Gaus, president and CEO of National Association of ACOs (NAACOS), said in a statement. “A lot has been accomplished in a relatively short amount of time, and ACOs are on the front line of redesigning healthcare delivery. This is a moment to celebrate them and their hard work.”
Most of the MSSP participants are in Track 1 of the program, which doesn’t involve downside risk. Of the 480 ACOs participating in 2017, 438 are in MSSP Track 1, with 42 in the two-sided risk tracks (six ACOs in Track 2, 36 in Track 3). Under current regulations, all participants have to take on risk beginning in 2019, but Gaus has argued CMS should allow organizations to stay in the one-sided Track 1 if they’ve shown they can generate savings and quality improvements.
Similar positive results on savings were shown with the smaller Next Generation and Pioneer ACO models. Unlike previous years, CMS didn’t publicize those results, with a spokesperson telling HealthExec they don’t account for “spillover effects of ACOs on the market.” CMS declined to comment on the MSSP results.