10 things to know on the Medicare Shared Savings Program & Pioneer ACO — Savings reach $1.29B in 3 years

Practice Management

The Centers for Medicare and Medicaid Services released new figures last week on the Medicare Shared Savings Program and Pioneer ACO, and the results were reported in Medscape.

Here are 10 things to know:

 

1. Both programs served more than 7.7 million Medicare beneficiaries and they saved CMS $466 million last year. The MSSP saved $429 million.

 

2. Medicare ACOs including both physician practices and hospitals have generated $1.29 billion in Medicare savings over the past three years.

 

3. There were 119 MSSP ACO participants that shared in the savings last year and six of the 12 pioneer ACO programs earned shared savings. There were 83 other ACOs that beat benchmarks but didn’t report enough for the shared savings.

 

4. Overall, 31 percent of the ACOs generated savings above minimum savings rate, up over 28 percent in 2014. CMS reported as ACOs gain experience they will be more likely to receive shared savings.

 

5. MSSP ACOs reported improving on 84 percent of quality measures reported in 2014 and 2015. The average quality score improved more than 15 percent on four preventative measures, according to the report:

 

• Screening for future falls risk
• Depression screening and follow-up
• Blood pressure screening and follow-up
• Providing pneumonia vaccinations

 

6. Nearly all of the ACOs participating in MSSP are in the track 1 of the program which doesn’t require them to take a share of the losses; only 5 percent are in track 2 or track 3, which requires them to take on greater downside risk for higher portions of shared savings.

 

7. There were only 12 of the original 32 Pioneer ACOs still in the program at the end of last year, with eight generating savings and six with sufficient savings to receive a portion of them. There were four that generated losses but only one that owed CMS, according to the report.

 

8. In 2015, there were 392 participating ACOs, up from 333 in 2014. This is a slower increase than the previous year, in which the number of ACOs grew from 220 in 2013.

 

9. The ACO participant composition breakdown:

 

• 54 percent had practice networks
• 31 percent had practice groups
• 38 percent had hospital/professional partnerships
• 31 percent of hospitals employed physicians

 

10. Fourteen percent of the MSSP ACOs were federally qualified health centers; 15 percent were rural health clinics and 13 percent were critical access hospitals.

 

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