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Eighty-nine new accountable care organizations will join the Medicare Shared Savings program in 2015, bringing the total number of participants to 405.
Eighty-nine new accountable care organizations (ACOs) will join the Medicare Shared Savings program in 2015, bringing the total number of participants to 405.
The Centers for Medicare and Medicaid Services (CMS) announced the additions December 22.
ACOs are provider-led groups that link payment to 33 quality improvement measures for a defined population. If providers reduce expected spending while meeting quality metrics, they receive a portion of the savings.
CMS recently released 2012 performance data on the Shared Savings program that showed, of 114 participating ACOs, 29 met the financial target, saving $128 million and receiving $126 million in bonus payments. Participating ACOs improved on 30 of the 33 quality metrics in the first two years, including clinician ratings by patients, clinician communication, doctor ratings by beneficiaries, and high blood pressure screening.
In 2014, existing ACOs added 17,000 providers to the program, and the 89 new ACOs are expected to bring another 23,0000 into the fold, according to CMS.
The new influx of participants might have been spurred on by a recent announcement by CMS that it plans to give providers more time before they would become liable for losses. Currently, participants entering the Shared Savings program have to transition to a two-sided risk model after three years. CMS proposed on December 1 to extend that timeframe by another three years.
CMS is also proposing a new two-sided model known as Track 3 which would allow ACOs to keep up to 75% of the money they save Medicare. They would also be responsible for up to 15% of losses if benchmarks aren’t achieved.
The agency also operates the Pioneer ACO program. First-year performance for that model show that one-third of participants reduced costs, but all met the quality metrics. In 2013, of 19 participating Pioneer ACOs, all met the quality metrics but half didn’t realize any cost savings, and the worst performing ACO recorded losses of more than $9.3 million, or 7% of expected expenditures. The best performer of the group saved about $23 million, and as a group, they saved Medicare $372 million.