Medicare Shared Savings Program and Pioneer ACO Model Show Ongoing Improvements

Added on Sep 22, 2016

Medicare Shared Savings Program and Pioneer ACO Model Show Ongoing Improvements in Cost Savings and Patient Care
From Industry Edge September 2016

Physicians, hospitals and health care providers participating in Accountable Care Organizations (ACOs) continue to substantially improve the quality of care for a growing number of Medicare beneficiaries, while achieving cost savings, according to the latest news from the Centers for Medicare & Medicaid Services (CMS).

In addition to better care for more than 7.7 million Medicare beneficiaries, CMS said the 2015 performance year results for the Medicare Shared Savings Program and Pioneer Accountable Care Organization Model show that Medicare ACOs had combined total program savings of $466 million, which includes all ACOs’ experiences for 392 Medicare Shared Savings Program participants and 12 Pioneer ACO model participants. Collectively, Medicare ACOs have generated more than $1.29 billion in total Medicare savings since 2012, according to CMS.

ACOs are judged on their performance and improvement on metrics that assess the care they deliver, including how highly patients rated their doctor, how well clinicians communicated, whether patients were screened for high blood pressure and clinicians’ use of electronic health records. According to CMS, all 12 participants in the Pioneer ACO Model improved their quality scores from 2012 to 2015 by more than 21 percentage points, and overall quality scores for nine out of 12 Pioneer participants were higher than 90% in 2015.

Meanwhile, ACOs in the Medicare Shared Savings Program that reported in both 2014 and 2015 improved on 84% of the quality measures that were reported in both years. Additionally, from 2014 to 2015, average quality performance improved by more than 15% on key preventive care measures, including screening for risk of future falls, depression screening and follow-up, blood pressure screening and follow-up, and providing pneumonia vaccinations.

By meeting quality performance standards and their savings thresholds, 125 ACOs qualified for shared savings payments in 2015, CMS said.