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.
2023 Drug Trend Report - Xevant
May 16th 2024To effectively navigate the changing pharmacy landscape and maintain a robust, cost-effective pharmacy benefit, you must understand the forces behind rising drug trend. What’s driving your costs and what can you do about it? As a leader in the PBM analytics space, we offer a unique perspective on pivotal trend drivers. Here’s what our comprehensive analysis revealed: -A surge in utilization rates across specialty and non-specialty drugs, magnified by anti-obesity therapies -Financial strain imposed by anti-inflammatory biologics and the yet-to-be-fulfilled -promise of biosimilar savings -Persistent price inflation driving higher costs year over year
Read More