More than 400 Medicare ACOs generated some $466 million in savings, said Patrick Conway, MD, Chief Medical Officer of the Centers for Medicare and Medicaid Services on August 25. Of those, 125 qualified for shared savings payments by meeting quality performance standards.
Eighty-three ACOs had healthcare costs lower than their benchmark but did not qualify for shared savings.
In 2015, Medicare ACOs included 392 Medicare Shared Savings Program participants and 12 Pioneer ACO model participants.
Collectively since 2012, CMS reported Medicare Accountable Care Organizations have generated more than $1.29 billion in total Medicare savings.
While the number of Pioneer ACOs decreased between 2014 and 2015, they still generated total model savings of over $37 million.
Overall quality scores for nine out of 12 Pioneer ACOs were above 90 percent in 2015. All Pioneers improved their quality scores from 2012 by over 21 percentage points.
Of the eight Pioneer ACOs that generated savings, six generated savings outside a minimum savings rate and earned shared savings.
Of four Pioneer ACOs that generated losses, one owed shared loss.
Under the proposed quality payment program, providers that participate in advanced ACO models may qualify for an exemption from payment adjustments under the merit-based incentive payment system, as well as additional incentive payments beginning in 2019 for participating in advanced alternative payment models.
The CMS report also indicated there were more ACOs shared savings in 2015 than 2014. Conway explained those with experience tend to perform better over time.
In comparing results in 2015 to 2014, average quality performance improved by more than 15 percent on key preventative care measures including screening for risk for future falls, depression screening and follow-up, blood pressure screening and follow-up and providing pneumonia vaccinations.
"The coordinated, physician-led care provided by Accountable Care Organizations resulted in better care for over 7.7 million Medicare beneficiaries while also reducing costs," said CMS Acting Administrator Andy Slavitt.
Accountable Care Organizations are judged on their performance, as well as their improvement, on an array of metrics that assess the care they deliver. Those metrics include how highly patients rated their doctor, how well clinicians communicated, whether patients are screened for high blood pressure and their use of electronic health records.
Accountable Care Organizations in the Medicare Shared Savings Program reported in both 2014 and 2015 improving on 84 percent of the quality measures that were reported in both years.
Since the passage of the Affordable Care Act, more than 470 Medicare Accountable Care Organizations – serving nearly 8.9 million Medicare beneficiaries – have been established through the Medicare Shared Savings Program, the Pioneer Accountable Care Organization Model, the Next Generation Accountable Care Organization Model, and the Comprehensive End-Stage Renal Disease Care Model.
"Accountable Care Organization initiatives in Medicare continue to grow and achieve positive results in providing better care and health outcomes while spending taxpayer dollars more wisely," Conway explained. "CMS continues to work and partner with providers across the country to improve the way healthcare is delivered in the United States."
