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Alternative payment models (APM) primarily run by Medicare have generally produced modest savings and quality improvements. However, popular APMs including accountable care organization (ACO) and bundled payment models have high drop-out rates, which may indicate a problem with downside risk, according to a new review article in Health Affairs.
The article reviewed 40 APMs operated by the CMS Innovation Center, including the Medicare Shared Savings Program (MSSP), Bundled Payments for Care Improvement (BPCI), Comprehensive Care for Joint Replacement (CJR) model, and the Comprehensive Primary Care Plus (CPC+) initiative.
The review found that population- and episode-based payment models – which largely cover ACO and bundled payment programs – generated some savings on average, with ACO models making the biggest impact overall. Bundled payment savings largely depended on the model.