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ACOs Show That Less Is More in 2014

September 16, 2015:

Lower costs can go hand in hand with improved care and patient experience, judging by the recently released quality and performance results for Medicare accountable care organizations. The results show that in 2014, 353 ACOs generated more than $411 million in total savings while quality of care and patient satisfaction measures went up.

The ACOs reviewed included 20 in the Pioneer Performance program and 333 in the Medicare Shared Savings Program. The Pioneer ACOs, distinguished by having instituted coordinated care and an infrastructure for delivering such care early, assume more financial risk than do Medicare Shared Savings ACOs. They realized model savings of $120 million in 2014 and boosted the mean quality score to 87.2 percent (an increase from the previous year’s 85.2 percent), most notably in medication reconciliation, clinical depression screening and creation of a follow-up plan, and qualifying for electronic health record incentive payments. These ACOs also improved the average performance score for patient and caregiver experience in five out of seven measures as compared with 2013.

Of the ACOs in the Shared Savings Program, 181 reduced health care costs at least to their benchmark, with those in the program longer being more successful. For those reporting in both 2013 and 2014, ratings improved in 27 out of 33 quality measures, including clinician communication, beneficiaries’ rating of their doctors, screening for tobacco use and cessation, high blood pressure screening, and electronic health record use.

As for the “shared savings” part of the programs, 11 of the 20 Pioneer ACOs achieved enough savings to qualify for payments of $82 million. Just three of the 20 exceeded threshold losses and must pay the Centers for Medicare and Medicaid Services $9 million in shared losses. Total model savings per ACO jumped to $6.0 million in the third performance year (2014), as compared with just $2.7 million in the first performance year.

Among the Shared Savings Program ACOs, 92 kept spending below their benchmarks and earned $341 million in program savings. In 2013, just 58 ACOs were able to keep spending below their targets. None of the few ACOs in the track 2 risk plan (sharing in both savings and losses) owed on excessive losses.


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