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New analysis from Avalere finds that physician-led accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) outperformed hospital-led ACOs by a significant margin. Additionally, MSSP ACOs continue to achieve higher savings the longer they participate in the program. The MSSP is Medicare’s largest alternative payment model and seeks to transition Medicare away from fee-for-service payment into a new value-based environment. In 2018, 548 MSSP ACOs provided care to over 10 million Medicare beneficiaries and reduced Medicare spending by $739M.
Under the Pathways to Success changes to the MSSP, CMS now classifies ACOs as “low revenue” or “high revenue” based on a threshold of Medicare Parts A and B revenue for ACO participants that is associated with the ACO’s assigned beneficiaries. This distinction is made by CMS to classify ACOs as physician led or hospital led, respectively.