Medicare Accountable Care Models Off to a Good Start

The Centers for Medicare and Medicaid Services (CMS) released its interim financial results for select Medicare Accountable Care Organization (ACO) initiatives at the end of January and, for a fledgling program, the results are promising.

“These innovative programs are showing encouraging initial results, while providing valuable lessons as we strive to improve our nation’s health care delivery system,” US Health and Human Services Secretary Kathleen Sebelius said in the CMS press statement on January 30, when the results were released. “Today’s findings demonstrate that organizations of various sizes and structures across the country are working with their physicians and engaging with patients to better coordinate and deliver high quality care while reducing expenditure growth.” 

The results for the Medicare Shared Savings Program ACOs show that, in their first 12 months, nearly half (54 out of 114) of the ACOs that started program operations in 2012 already had lower expenditures than projected. Of the 54 ACOs that exceeded their benchmarks in the first 12 months, 29 generated shared savings totaling more than $126 million – a strong start this early in the program. In addition, these ACOs generated a total of $128 million in net savings for the Medicare Trust Funds. ACOs share with Medicare any savings generated from lowering the growth in health care costs while meeting standards for high quality care.  Final performance year-one results will be released later this year.    

The North Carolina Medical Society (NCMS) supports the development of accountable care organizations and has spearheaded the Toward Accountable Care (TAC) Consortium and Initiative to provide resources to physicians interested in transitioning to this model of care. Visit the TAC website here. [See an article from the January 25, 2014 edition of The Asheville Citizen Times on the Western North Carolina Pediatric Care Collaborative targeting obesity and asthma that was first featured on the TAC website, here.]

To read the National Association of ACOs take on the interim financial results, click here.

 
 

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3 Comments

  • Stephen W. Nuckolls

    I agree with Dr. Terrell that transitioning to a value based delivery system is a difficult process that does not happen quickly. While we did not qualify for an interim payment, our first year experience showed improvements in both quality and cost. Our cost benchmark is also well below the median, but we remain committed to the program and its goals and will work with CMS, Congress, and others to help them make improvements.

  • The transition to deliverying accountable care from our current volume-based health care delivery system is hard work, but it is necessary. As the US House’s SGR agreement yesterday confirmed, payment for quality and value rather than fee-for-service will occur regardless of physician acceptance. The Medicare Shared Savings Program is an early stage program that will continue to evolve over time. Cornerstone’s first-year experience shows our quality improved and our overall costs are substantially lower than the majority in the MSSP. With that information we will continue to improve our processes and work with all of our payers to improve our outcomes and anticipate financial success as a result. We are playing the long game,not the short one.

  • Kerry Willis

    Harrah’s at Cherokee gives odds for leaving with bonus money that are better

    29/114 qualified for a shared savings and primarily in areas with a high benchmark not consistent with most of NC.Two of those failed to qualify for a bonus because of quality reporting failures

    25 more achieved savings to medicare but failed to meet the threshold for a bonus

    $400 million invested and hundreds of millions in operating costs should make anyone be cautious about entering this market. Most analysts feel these
    results are disappointing and expose major structural problems in the MSSP program unless significant changes are made.