A Dip in MSSP ACO Numbers, But Up Is the Direction in ACO Reach, CMS Announces

The number of accountable care organizations (ACOs) participating in CMS’ main ACO program is lower this year than in 2022, according to an CMS announcement today.

This year, the Medicare Shared Savings Program (MSSP) will have 456 participating ACOs, down from 483 last year and a decrease of 105 from the peak number of 561 participating ACOs in 2018.

The number of assigned beneficiaries in MSSP ACOs also dipped, to 10.9 million this year from 11 million in 2022.

In 2020, the peak year for assigned beneficiaries in MSSP ACOs, 11.2 beneficiaries were assgined to the ACOs.

ACOs are one of the main vehicles for value-based care, which is supposed to shift the financial incentives in healthcare from fee for service, which rewards providers for volume and intensity of services to prevention and care coordintion. The MSSP program is one of the federal government's signature value-based care program and was created by the provisiosn in the 2010 Affordable Care Act.

The slide in MSSP ACOs and has been offset by the growth of the ACO Realizing Equity, Access, and Community Health (REACH) program, which started in in 2021 and has the state purpose of bringing coordinated and value-based treatment to underserved populations. The number of ACOs in the ACO Reach program increased to 132 this year, up from 99 last year, and the number of assigned beneficiaries increased to 2.1 million, up from 1.8 million last year. Today’s announcement also says that 824 federally quality health centers, rural health centers and critical access hospitals will be part of a REACH program ACO this year, which is more than double than the number — 406 — that were part of REACH ACOs last year.

CMS also announced today that four Kidney Care First (KCF) practices and 50 Kidney Contracting Entities (KCEs) are joining the Kidney Care Choices model this year.

Twenty-six 26 KCF practices and 50 KCEs are continuing in the program from last year, bringing the totals to 30 KCF Practices and 100 KCEs.

The National Association of ACOs (NAACOS) put out an upbeat new release today about the ACO numbers. “We expect 2023 to be a turning point for ACOs and growth in participation to really accelerate in 2024 thanks to CMS leadership,” Clif Gaus, Sc.D., president and CEO of the organization, was quoted as saying in the news release.