Hospitals, Payers

ACOs saved Medicare $466M in 2015, but nearly half produced no savings

Still, 190 of participating Medicare ACOs — 49 percent — did not generate any savings in 2015, CMS said.

Medicare quality measure

Despite many bumps in the road, Pioneer Accountable Care Organizations and the Medicare Shared Savings Program have saved taxpayers $1.29 billion in four years and improved patient outcomes, the federal Centers for Medicare and Medicaid Services announced Thursday.

Medicare ACOs generated $466 million in savings in 2015, the fourth year of the Pioneer ACO program and the Medicare Shared Savings Program. That includes 392 MSSP participants and the 12 remaining Pioneer ACOs; the latter is down from 32 at the program’s outset in 2012.

Together, ACOs in the two programs cared for 7.7 million Medicare patients last year.

Significantly, nine of the 12 Pioneer ACOs achieved 90 percent of their quality goals in 2015, with the mean quality score at 92.26 percent, up from 87.2 percent a year earlier. All 12 improved their quality scores by an average of 21 percentage points over the four years they participated, CMS reported.

Among the 392 organizations in the MSSP last year, 119 earned shared savings. Another 83 had costs lower than Medicare benchmarks, but didn’t share in savings because they didn’t meet the CMS minimum savings threshold. That means 190 of those ACOs — 49 percent — did not generate any savings in 2015.

Earlier participants were more likely to qualify for shared savings, according to CMS. Some 42 percent of those that started in 2012 made the threshold, compared to 21 percent of ACOs that joined the program in 2015.

On the quality front, ACOs in the MSSP showed an improvement from 2014 to 2015 on 84 percent of quality measures they reported, according to CMS. They saw particularly good improvements in screening for future fall risk, depression and blood pressure, as well as in vaccinating patients against pneumonia.

Both the Medicare Shared Savings Program and the Pioneer ACO model resulted from the 2010 Affordable Care Act. (Tell your friends outside of the healthcare industry that Obamacare isn’t just about insurance coverage. They might not believe you.)

CMS officials released some really trite statements about the results, and we won’t bore you with them here. However, in a teleconference with reporters, CMS Chief Medical Officer Dr. Patrick Conway did say that his mother is covered by an ACO. CNBC reported that Conway’s mom received a call from a care coordinator on Wednesday to schedule follow-up care.

The Phoenix Business Journal reported that Arizona-based Banner Health was the top performer among Pioneer ACOs for the fourth year in a row. The publication said Banner was responsible for 66 percent of all savings created by the 12 Pioneer ACOs in 2015.

Photo: Flickr user Andrew Hurley

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