In December of 2018, the Trump Administration overhauled the largest value-based payment program in fee-for-service Medicare—the Medicare Shared Savings Program (“Shared Savings Program” for short) for “Accountable Care Organizations” or ACOs. ACOs are groups of health care providers that agree to be held accountable for the quality, cost, and experience of care for a population…
The CMS achieved savings from the Medicare Shared Savings Program last year, marking the second year in a row the agency turned a profit from the program. About 66% of the 548 Medicare accountable organizations produced a total of $1.7 billion in savings in 2018 and the CMS scored a $739.4 million gain, according to new agency…
The Centers for Medicare & Medicaid Services has released a guide showing which Medicare Shared Savings Program tracks for 2019 qualify as an alternative payment model or advanced APM under the Quality Payment Program. The guide also explains whether eligible clinicians participating in an MSSP accountable care organization are eligible for the Merit-based Incentive Payment System APM…
Physician-group accountable care organizations (ACOs) are not only more likely than hospital-integrated ACOs to be associated with savings in the Medicare Shared Savings Program (MSSP), but their savings grew over 3 years, according to research published in The New England Journal of Medicine (NEJM). Past research has shown that physician-led ACOs are more successful. The…
As described in our previous post, the MSSP saw for the first time a net savings for Medicare as calculated based on actual payments to ACOs (including bonuses) versus their benchmarks. The continuing trend of increasing net savings relative to benchmarks is consistent with a similar trend toward greater savings in “counterfactual” analyses that show…
As in previous years, MSSP ACOs showed strong performance on quality of care measures. But many of the proposed reforms in the program center on whether a redesign could increase the modest savings that have been estimated by the Medicare actuaries and other researchers in the program to date. In this, the first post of…
New analysis from Avalere finds that accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) achieve higher savings for Medicare the longer they are in the program. ACOs in the MSSP for 4 or more years were responsible for nearly all of the program’s previously reported $314 million in savings in 2017, the…
Something really quite extraordinary happened this week: NAACOS, the Washington, D.C.-based National Association of Accountable Care Organizations, published, in the august journal Health Affairs, a study based on research that NAACOS leaders had commissioned from Dobson DaVanzo & Associates, a healthcare economics consulting firm. And, as Healthcare Informatics Managing Editor Rajiv Leventhal noted in his…
The Medicare Shared Savings Program (MSSP) is the nation’s single largest initiative to move the US health care system from volume to value. In only six years, the MSSP has grown to include 561 participating accountable care organizations (ACOs) serving 10.5 million assigned beneficiaries – nearly one-third of traditional Medicare beneficiaries with Part A and…
The CMS made a profit from the Medicare Shared Savings Program last year as more accountable care organizations moved to risk-based contracts and gained experience, new federal data show. About 60% of the 472 Medicare ACOs generated a total of $1.1 billion in savings in 2017, according to the CMS data set released Thursday. The…