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Robert B. Vogel, MD, JD
Retinal Ophthalmologist at Piedmont Eye Center, Lynchburg VA;
Attorney, Overbey Hawkins & Wright, PLLS, Lynchburg, VA;
Adjunct Professor, Humanities and Bioethics, Liberty University School of Medicine, Lynchburg, VA.
Thirty-one percent of accountable care organizations (ACOs) qualified for bonuses from the Medicare Shared Savings Program (MSSP) based on their 2015 performance – the highest number to date, according to the Centers for Medicare & Medicaid Services (CMS).
According to CMS data, 400 Medicare ACOs generated more than $466 million in total program savings in 2015. Of these, 125 qualified for shared savings payments by meeting quality performance standards and their savings threshold — an increase from 2013 and 2014 when 28% and 26%, respectively, qualified for bonuses. The total savings to the Medicare program grew 13% from $411 million in 2014.
The ACOs with more experience in the Pioneer ACO Model and the Medicare Shared Savings Program tend to perform better over time, CMS says. Shared Savings Program ACOs that reported quality in both 2014 and 2015 improved on 84% of the quality measures. The average quality performance improved by more than 15% between 2014 and 2015 for four measures: screening for risk of future falls, depression screening and follow-up, blood pressure screening and follow-up, and providing pneumonia vaccinations. More than 91% of ACOs in a second or third performance year during 2015 increased overall quality performance scores through Quality Improvement Reward points in at least one of four quality measure domains.
“The results are not as strong as we, and many of our ACO members, had hoped for. But overall we are pleased to see the results show a positive trend for the program,” said National Association of ACOs president and CEO Clif Gaus in a statement. “These ACOs are on the front line of redesigning the healthcare industry, and this is a moment to celebrate them and their hard work.”