Throughout the last decade of ACO development, many have struggled to identify what actually makes ACOs successful. Analyses have been fraught with conflicting conclusions. Studies have tagged type of ownership (hospital-based vs. physician-led), geographic region or urban-rural factors, primary-care-only versus specialty participation, ACO payment model type, patient volume, and operations strategies as links to success…
When the Centers for Medicare and Medicaid Services (CMS) have announced the 2020 results for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) in early September, Intermountain Healthcare’s Castell Accountable Care organization was revealed to have received a quality score of 97.03 percent and to have generated $11.5 million in savings for Medicare. The…
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At the beginning of this series, we laid out a basic tenet: As shared savings plan ACOs, you need to do as well or better at lowering costs than competing value-based payment models. Otherwise, your resources and support will dwindle in favor of more promising avenues to control Medicare spending, and competition will stifle your…
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As we reported in a news article on Sept. 30, “A dispute has arisen over controversial statements made by two prominent healthcare policy leaders around the Medicare Advantage program. On Sept. 30, Donald Berwick, M.D., and Richard Gilfillan, M.D., published an article in the Health Affairs Blog entitled “Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2:…
Accountable care organizations (ACOs) can improve health equity in their patient populations, but they need more funding and flexibility to do so, according to a report from a group representing 370 ACOs. “ACOs are already beginning to do the work of addressing negative [social determinants of health] to improve quality and control costs for the…
Accountable care organizations (ACOs) participating in the Medicare Shared Savings Program had a record performance year in 2020. The ACOs saved Medicare $4.1 billion while achieving an average quality score of 97.8 percent. One of the health systems participating in the program—Advocate Aurora Health—led the nation in savings and quality. Advocate Aurora’s affiliated ACOs generated $110 million in…
Accountable Care Organizations (ACOs) have been around for more than a decade—created with the idea that integrating care providers across settings (hospitals, primary care, specialty care, etc.) and aligning their financial incentives would lead to improved clinical outcomes and lower healthcare costs. And indeed, some of the most effective and efficient healthcare organizations in the…
The Medicare Shared Savings Program (MSSP) is the largest value-based care program from the Center for Medicare & Medicaid Services (CMS) to date. As of 2020, there were 513 ACOs participating in the program, with a total shared savings of $2.28 billion.8 This program seeks to accomplish the following: Promote accountability among healthcare institutions for the…
