One study suggests that, after accounting for other factors, MSSPs do not have any impact on outcomes or costs.
In the effort to transition to value-based care, ACOs are leading the way. There are over 900 ACO contracts covering 32 million lives in the United States. One major part of that, Medicare Shared Savings Programs (MSSPs) are often cited as an example of a large-scale initiative that saves costs and improves outcomes. But do they?
A new study from researchers at the University of Michigan School of Public Health, and published in the Annals of Internal Medicine, suggests that while most other studies show that MSSP ACOs do result in at least some improved outcomes and lowered costs, accounting for nonrandom clinician exits suggests no real significant outcomes.
Related: Lessons Learned From MSSP ACOs: What Execs Should Know
The reason for the lack of improvement, according to the study, is because higher-cost clinicians and beneficiaries are more likely to exit MSSP ACOs, potentially distorting data on costs and outcomes in other studies.
“Our results suggest that improved quality and spending performance in this voluntary program may have been driven by nonrandom exit of clinicians and their patient panels from the MSSP,” said the authors.
The authors concluded that pruning those high-cost physicians could have significant impact on purported savings and even explain the phenomenon that some have found that MSSP savings increase over time.
Optimize Your Healthcare Payments with Optum Financial
April 29th 2025Discover how Optum Financial is revolutionizing healthcare payments in our latest whitepaper. Learn how transitioning to electronic payments can reduce administrative costs, streamline claims processing and enhance security.
Read More
Conversations With Perry and Friends
April 14th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.
Listen
Healthcare hasn't been a priority of the second Trump administration so far, panelists at the Asembia agreed. Medicaid may loom large, though, as the administration and congressional Republicans look for ways to slash government spending as a way of offsetting major tax cuts.
Read More
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
What 5 Managed Care Trends Experts Say You’re Not Watching Closely Enough
April 29th 2025Managed Healthcare Executive asked several experts in healthcare and managed care to share the trends they think the industry is overlooking. From rising costs and data challenges to shifts in how care is delivered, these are the issues that could have a major impact — and deserve a closer look.
Read More