Healthcare Analytics, Population Health Management, Healthcare Big Data

Quality & Governance News

89 Accountable Care Organizations Join Medicare Savings Program

By Jennifer Bresnick

Eighty-nine new accountable care organizations (ACOs) will take part in the Medicare Shared Savings Program (MSSP) in 2015, CMS says.

- The Medicare Shared Savings Program (MSSP) will be expanding significantly with the addition of 89 new accountable care organizations (ACOs) starting January 1, 2015, announced CMS in a blog post this week.  The new ACOs will attempt to benefit from reducing spending, improving quality, and leveraging advanced health IT to coordinate care and manage population health.

With a total of 424 participants, including the Pioneer organizations, Medicare ACOs now cover more than 7.8 million beneficiaries.  Non-Medicare accountable care organizations and agreements are also becoming increasingly popular as payers invest in the principles of value-based reimbursement.  Accountable care may cover up to 130 million lives by 2017, and continue to achieve measurable improvements to patient safety and overall healthcare costs.

“ACOs are one part of this Administration’s vision for improving the coordination and integration of care received by Medicare beneficiaries,” Sean Cavanaugh, Deputy Administrator and Director of the Center for Medicare says on the CMS blog.  “Since ACOs first began participating in the program in early 2012, thousands of health care providers have signed on to participate in the program, working together to provide better care to Medicare’s seniors and people with disabilities.”

“In 2014 alone, existing Shared Savings Program ACOs added almost 17,000 healthcare providers, and the 89 new ACOs will bring approximately 23,000 additional physicians and other providers into the ACO program starting January 1,” he added. “The growth of this program for providing health care has been continued and consistent since its inception, and we are encouraged by that interest.”

The most recent results from the MSSP have been encouraging, with high performance on the majority of care quality measures.  The program has produced $417 million in savings since its inception in 2012.  Accountable care principles and measures of the Affordable Care Act may be the only things keeping Medicare solvent, CMS said over the summer, as healthcare struggles to keep rampant spending under control through the spread of pay-for-performance reimbursement and a renewed focus on the safety and quality of patient care.

A recently proposed rule would further these accomplishments by requiring ACOs to develop a plan for leveraging health IT, including EHRs, telehealth, clinical analytics, and health information exchange, as part of their overall strategies.  The rule allows flexibility as ACOs build their health IT infrastructures and gear their technologies towards care coordination and population health management.

“We continue to believe that ACOs should coordinate care between all types of providers and across all services, and that the secure, electronic exchange of health information across all providers in a community is of the utmost importance for both effective care coordination activities and the success of the Shared Savings Program,” the rule said. “ACOs have reported how important access to real time data is for providers to improve care coordination across all sites of care, including outpatient, acute, and post-acute sites of care.  We believe that providers across the continuum of care are essential partners to physicians in the management of patient care.”

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