HIMSS News

CMS Announces Positive Results from the 2015 Performance Year for ACO Programs

n Thursday, August 25, the Centers for Medicare & Medicaid Services (CMS) released performance results for 2015 that show Medicare Accountable Care Organizations (ACOs) delivered higher quality care for Medicare beneficiaries and generated financial savings. 

 

In terms of savings, the 404 Medicare ACOs generated over $466 million in total program savings, with 125 of these ACOs qualifying for shared savings by meeting quality performance standards and their savings threshold.  While the cohort of Pioneer ACOs decreased between 2014 and 2015, the 12 program participants still generated total model savings of over $37 million.  The 392 Shared Savings Program ACOs generated total program savings (inclusive of all savings and losses relative to financial benchmarks) of $429 million. Of these participating ACOs, 119 ACOs earned shared savings by holding spending far enough below their financial benchmarks and meeting quality standards. 

In addition, all 12 Pioneer ACOs improved their quality scores from 2012 to 2015 by more than 21 percentage points.  Overall quality scores for nine out of 12 Pioneer participants were more than 90 percent in 2015.  Shared Savings Program ACOs also continued to show improvement, as ACOs that reported in both 2014 and 2015 improving on 84 percent of the quality measures that were reported in both years. 

The Pioneer ACO Model is designed for health care organizations and providers that are already experienced in coordinating care for patients across care settings. It allows physicians and health care providers to move more rapidly from a shared savings payment model to a population-based payment model on a separate track from the Medicare Shared Savings Program.  Shared Savings was established by the Affordable Care Act to facilitate coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service beneficiaries and reduce unnecessary costs.