Outlook Bright for CMS ACO Programs, Says Signify’s Gronniger

Participation in the main Medicare Shared Savings Program is decreasing but 132 accountable care organizations with 2.1 million assigned beneficiaries are participating in the ACO REACH model this year.

Although the number of Medicare Shared Savings Program accountable care organizations (ACOs) has dipped from last year, the bigger picture includes the growing number of ACOs in CMS’ ACO Realizing Equity, Access, and Community Health (REACH) model, says Tim Gronniger, M.P.P., chief value-based solutions officer at Signify Health.

“I see them as sister programs,” says Gronniger, who also noted that number of providers per ACO is growing.

The Medicare Shared Saving Program (MSSP) is CMS’s largest ACO program and a mainstay of its efforts to move to value-based care, which is supposed to incentivize cost-effective care and prevention, and away from fee-for-payment.

CMS announced earlier this week that the number of ACOs participating in MSSP program dipped from 483 in 2022 to 456 this year and the number of Medicare beneficiaries assigned to those ACOs also declined, form 11 million to 10.9 million.

But CMS announced at the same time that number of ACOs in the ACO REACH model increased from 99 last year to 132 this year and that the number of assigned beneficiaries in those Reach ACOs increased from 1.8 million last year to 2.1 million this year.

Signify Heath bills itself as a leader in “ACO enablement,” and the company says it added 37 new health systems to MSSP ACOs this year. All told, Signify says it will support 190 providers in MSSP ACOs this year and 700,000 assigned beneficiaries.

Gronniger, who is on the board of the National Association of ACOs (NAACOS), echoes some of the same views that were in the NAACOS news release about this week’s CMS announcement, which were also in the CMS news release. The CMS news release that came out on Tuesday says that changes in the physician schedule fee are expected to increase participation in the MSSP ACO program next year and beyond.

““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 NAACOS, was quoted as saying in the NAACOS press release.

All of the ACOs that Signify works with are in the MSSP program, including 150 clients in the program’s Enhanced Track, which puts providers at the greatest risk if quality and financial benchmarks aren’t met but also includes the greatest rewards if they are, according to the company.

But Gronniger said the ACO Reach program has some features that would make it more appealing to many providers, including upfront monthly payments and policies that make it easier to assign patients seen by nurse practitioners to ACOs.