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If any vignette defines the provider experience in a Medicare accountable care organization (ACO), it is probably the anxious waiting, digesting, and analyzing of the Centers for Medicare and Medicaid Services (CMS) quarterly reports of ACO performance against its benchmark. In offices across the United States, ACO executive directors and analytics teams pore over tables and cross-tabs trying to assess their results, asking “are we meeting our goals for the year? Are we on track to generate shared savings?”
The reality is that most of these conversations are moot because the vast majority of Medicare ACOs are too small to conclude with any certainty that their measured performance is reflective of their true performance, instead of the result of statistical variation.
Fortunately, this problem is solvable but only if ACOs are large enough to reliably interpret the performance of their networks. While the majority of ACOs do not serve large enough populations to manage the number of lives needed for statistical reliability, providers can do so without acquisition, consolidation, or any other threat to independence by creating collaborative ACOs.