According to data recently released by the Centers for Medicare and Medicaid Services (CMS) accountable care organizations (ACOs) saved Medicare a whopping $4.1 billion in 2020, almost $2 billion after taking out the $2.3 billion in shared savings. The data shows an improvement over the $2.6 billion in shared savings ($1.9 after taking out shared savings) that were generated by ACOs in 2019.
ACOs take on financial risks and receive shavings if they meet certain quality and spending benchmarks. If they do not reach the requisite thresholds, then they must repay Medicare. According to the data, there are 513 ACOs that participate in the Medicare Shared Savings Program (MSSP). The ACOs generated $390 in gross savings per beneficiary and 345 out of the 513 ACOs received shared savings (67%). Additionally, 75% of shared savings-only ACOs produced gross savings and 55% earned shared savings. 97% of at-risk ACOs produced gross savings and 88% earned shared savings.
The National Association of Accountable Care Organizations (NAACOS) noted that ACOs had an average quality score of almost 98% and 60 ACOs received a perfect score.
ACOs are trying to reverse a decline in MSSP participation over the last few years: as noted above 513 ACOs participated in 2020 as compared to the high of 561 in 2018. 2020 participation numbers was an increase however, from the 487 that participated in the program in 2019.
“During the pandemic-stricken year of 2020, ACOs were valuable assets in managing patient care,” NAACOS said in a release. “Given their accountability to long-term patient care and outcomes, ACOs were proactive in their outreach to high-risk patients to keep them healthy, quickly established telehealth and remote monitoring capabilities to continue to provide care.”
NAACOS also pointed out that in addition to the positive results from 2020, multiple analyses have shown ACOs are lowering Medicare spending by 1 to 2%, which equates to tens of billions of dollars of reduced Medicare spending when compounded annually.
Bipartisan legislation introduced in the United States House of Representatives focuses on stopping the participation decline as well, by attempting to raise the amount of shared savings an ACO can achieve through MSSP, among other reforms.
This “data underscores the need for policymakers to do all they can to grow the ACO model and extend the program’s benefits to more patients,” said Clif Gaus, Sc.D., President and CEO of NAACOS. “We currently have the fewest number of Shared Savings Program ACOs since 2017. That trend must be reversed, given continued debate about ways to improve our health system.”