Low-revenue MSSP ACOs Produced Better Results in 2021 Than High-revenue ACOs: CMS

The Centers for Medicare and Medicaid Services released results today showing that on a per capita basis, the net savings for low-revenue accountable care organizations (ACOs) was higher than the net savings for high-revenue ACOs.

Low is higher when it comes to the Medicare Shared Savings Plan (MSSP) accountable care organizations (ACOs) and net savings on a per capita basis, according to figures released today by the Centers for Medicare and Medicaid Services (CMS).

CMS said in a press release that low-revenue ACOs — those consisting mainly of physicians, serving rural areas or anchored in a small hospital — had higher net savings on a per capita basis than high-revenue ACOs.

The per capita in net savings for the low-revenue ACOs was $237 in 2021 compared with $124 for the high-revenue ACOs, according to the CMS press release.

The press release also says that MSSP ACOs with a high proportion of primary care physicians fared well in 2021. The net savings on a per capita for ACOs in which 75% or more of the providers were primary care clinicians was $281 compared with $149 for ACOs with a smaller proportion of primary care clinicians.

“These results underscored how important primary care is to the success of the Shared Savings Program and demonstrate how the program supports primary care providers,” the press release says. In 2021, the MSSP program included 477 ACOs.

CMS said that 58% of the participating ACOs earned payments for their 2021 performance.
The program as a whole saved Medicare $1.6 billion relative to spending targets, according to the press release. CMS says this was the fifth consecutive year the program generated overall savings and high-quality performance results.

The CMS figures come on the heels of a study published in JAMA Network Open last week that showed that the MSSP spending on a per-beneficiary basis was higher than Medicare
Advantage spending. The study conducted by University of Pennsylvania researchers looked at four health conditions — diabetes, congestive heart failure, chronic kidney disease and hypertension — at the Ochsner Health System in Louisiana from Jan. 1, 2014, through Dec. 31, 2018. Their results showed that MSSP spending was 23% (for congestive heart failure) to 30% (for chronic kidney disease) higher than MA spending.