Medicare ACOs participating in newest tracks achieved bigger savings in 2019

CMS announced Monday that accountable care organizations participating in the revised Medicare Shared Savings Program generated higher savings last year than organizations still in the legacy model.

Of the 541 ACOs in the Medicare Shared Savings Program in 2019, 205 participated for the first time in the revised program, called Pathways to Success, that involves requiring ACOs to take on downside risk sooner than in the original program. Those 205 ACOs achieved on average net savings of $169 per Medicare beneficiary last year compared to $105 in savings on average for the 336 ACOs in the legacy tracks, according to CMS Administrator Seema Verma in a Health Affairs blog post. Additionally, the 66 new entrants to the ACO program, which joined under Pathways to Success, achieved on average $150 in net savings, marking the first time ACOs new to the program performed better than the benchmark, Verma said.

“These early results suggest that greater financial accountability under the Pathways to Success policies has produced the stronger incentives for ACOs to deliver better coordinated and more efficient care for Medicare beneficiaries,” she said.

CMS overhauled the longstanding Medicare Shared Savings Program in December 2018 in response to concerns that the program wasn’t saving the agency money because the vast majority of ACOs stayed in upside-only risk tracks for many years. The modified program has received push back from the National Association of ACOs, which argues some of the changes deter new entrants to the program. Indeed, participation to MSSP has dropped from a peak of 141 new ACOs in 2018, to just 35 new ACOs joining in 2020.

Overall, the 541 ACOs saved Medicare $1.19 billion, which is higher than 2018 when the program saved Medicare about $740 million dollars.

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