Quality and Financial Performance Study Finds ACO Success
A CMS study found ‘substantial improvement’ to quality and financial performance for accountable care organizations.
- Earlier this month, the Centers for Medicare & Medicaid Services issued quality and financial performance results that focused on Medicare Accountable Care Organizations (ACOs). It found that ACOs have successfully improved the quality of care for Medicare beneficiaries by creating better collaboration between doctors, hospitals and healthcare providers to coordinate care.
In the 2013 version of the study, ACOs had a higher quality and better patient experience than published benchmarks. This year’s version shows even better improvement when compared to last year’s report and there is significant growth for almost all quality and patient experience measures demonstrating that these organizations are improving care. Pioneer ACO Models and the Medicare Shared Savings Program generated over $417 million in savings for Medicare and ACOs qualified for shared savings payments of $460 million.
Since the Affordable Care Act, more than 360 Medicare ACOs have been established, serving over 5.6 million Americans with Medicare. Both Pioneer ACO Models and the Medicare Shared Savings Program showed substantial improvements in the latest industry report.
Pioneer performance second year results – Pioneer ACOs showed improvements in three key areas: financial quality of care and patient experience. For finances, Pioneer ACOs generated savings of over $96 million and qualified for shared savings payments of $68 million. It saved the Medicare Trust Funds approximately $41 million.
Pioneer ACOs achieved lower per capita growth in spending for the Medicare program at 1.4 percent, which is 0.45 percent lower than Medicare fee-for-services. Eleven Pioneers ACOs earned savings, three generated losses and three elected to defer reconciliation until after the completion of performance of year three.
When it comes to quality of care, the quality score among Pioneer ACOs increased by 19 percent from 71.8 percent in 2012 to 85.2 percent in 2013. Organizations improved in 28 of the 33 quality measures and experienced average improvements of 14.8 percent across all quality measures. The average performance score for patient and caregiver experience in six out of seven measures.
Medicare shared savings program performance first year results – Fifty-eight Shared Savings Program ACOs held spending $705 million below the targets and earned performances payments of more than $315 million. The total net savings to Medicare is roughly $383 million in shared savings. An additional 60 ACOs reduced health costs compared to their benchmark, but did not qualify for shared savings, because they did not meet the minimum savings threshold.
Overall, Shared Savings Program ACOs improved on 30 of 33 quality measures. This includes such measures as patients’ ratings for clinicians communication, beneficiaries’ rating of the doctor, health promotion and education, screen for tobacco use and cessation and screening for high blood pressure. The Shared Savings Program ACOs achieved higher average performance rates on 17 of the 22 Group Practice Reporting Option Web Interface measures reported by other Medicare FFS providers.
