Last week, CMS sent out press releases touting over $1 billion in savings from Accountable Care Organizations. Here's the tweet from Andy Slavitt, the acting Administrator of CMS:
NEW ACO RESULTS: physicians are changing care, w better results for patients & are saving money. Over $1B. https://t.co/FEfe3QErb5
- Andy Slavitt (@ASlavitt) August 25, 2016
The link in the tweet is to a press release. The link in the press release citing more details is to another press release. There's little in the way of analysis or data about how ACOs did in 2015. So I decided to do a quick examination of how ACOs are doing and share the results below.
Basic background on ACOs:
Simply put, an ACO is a group of providers that is responsible for the costs of caring for a population while hitting some basic quality metrics. This model is meant to save money by better coordinating care. As I've written before, I'm a pretty big fan of the idea – I think it sets up the right incentives and if an organization does a good job, they should be able to save money for Medicare and get some of those savings back themselves.
ACOs come in two main flavors: Pioneers and Medicare Shared Savings Program (MSSP). Pioneers were a small group of relatively large organizations that embarked on the ACO pathway early (as the name implies). The Pioneer program started with 32 organizations and only 12 remained in 2015. It remains a relatively small part of the ACO effort and for the purposes of this discussion, I won't focus on it further. The other flavor is MSSP. As of 2016, the program has more than 400 organizations participating and as opposed to Pioneers, has been growing by leaps and bounds. It's the dominant ACO program – and it too comes in many sub-flavors, some of which I will touch on briefly below.
A couple more quick facts: MSSP essentially started in 2012 so for those ACOs that have been there from the beginning, we now have 4 years of results. Each year, the program has added more organizations (while losing a small number). In 2015, for instance, they added an additional 89 organizations.
So last week, when CMS announced having saved more than $1B from MSSPs, it appeared to be a big deal. After struggling to find the underlying data, Aneesh Chopra (former Chief Technology Officer for the US government) tweeted the link to me:
@RahulRajkumar11 @ashishkjha open data is now the default in government
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