ACOQuality and financial performance results issued

The Centers for Medicare & Medicaid Services (CMS) released a new set of quality and financial performance findings on September 16, 2014. These findings showed Medicare Accountable Care Organizations had elevated the quality of care for recipients through preventative health initiatives and collaborative efforts between doctors, hospitals, and care providers.

Savings on both sides

ACOs in the Pioneer ACOI and Medicare Shared Savings Program generated over $372 million in total program savings for Medicare ACOs, while qualified ACOs also saw $445 million in shared savings payments. This information is based on second year results of the 23 Pioneer ACOs and the first year results from 220 Shared Savings Program ACOs.

 

Medicare ACOs vs. Pioneer ACOs

Medicare ACOs groups of providers and suppliers of services that care for Medicare fee-for-service beneficiaries. Pioneer ACOs, however, are typically more financially sound organizations that take on higher financial risks and receive financial gains for keeping costs low.

 

Other major findings

Improvements were seen in financial aspects, patient experience ratings, and overall quality of care.

 

  • This year, the Pioneer ACOs saved the Medicare Trust Fund about $41 million.
  • The quality score for Pioneer ACOs jumped from 71.8% to 85.2%.
  • 11 of the Pioneer ACOs earned shared savings.
  • 53 Shared Savings Program ACOs held spending below their targets.
  • Shared Savings Program ACOs received higher average performance rates on 17 of the 22 Group Practice Reporting Option measures.

 

Slow process for change

The transition into Accountable Care won’t happen quickly—but these findings support growth in a positive direction. Through ACOs, greater collaboration between healthcare professionals and health systems means doctors are keeping healthy patients healthy, and are, in turn, lessening the burden on the healthcare system as a whole. But on the road to change, things progress slowly.

 

Your turn: What are your thoughts on the transition to an ACO model?