What’s Hot in ACO News: Summer 2016

Posted by Lauren Steckler, MHA, May 20th, 2016

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What’s happening in the world of Accountable Care Organizations? We think it’s important to know. Here’s a recap on the top ACO news from spring 2016.

1. Physicians are gravitating toward accountable care organizations.

You may already be one of the roughly 24 million Americans being served by an ACO. If not, just wait: Physician participation is increasing. The idea behind the ACO model is to bring higher quality care to patients and lower costs by reducing the use of unnecessary tests and treatment. Many physicians are joining ACOs to have access to a larger team of physicians and other experts to help manage their patients. The Department of Health and Human Services is encouraging more Medicare providers to consider models such as ACOs, in part to decrease runaway healthcare expenses, which are leading to higher Medicare premiums for some consumers. This article describes what you can expect if your provider joins an ACO and smart steps to take to get the most out of it.

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2. The American Medical Association called on CMS to refine Medicare Shared Savings to ramp up participation.

The American Medical Association (AMA), in comments signed by 20 other organizations, expressed strong support for the proposal by CMS to incorporate regional cost data into financial benchmarks. The current method of basing benchmarks solely on historical spending penalizes ACOs for performing well in the past. By blending historical and regional cost data, CMS will improve the long-term viability of the program by attracting new providers, while also enhancing the odds of retaining current participants. The joint comments represent the collective views of physicians, hospitals, medical group practices, academic medical centers, and nearly all existing Medicare Shared Savings Program ACOs.

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3. Physician-sponsored accountable care organizations may be performing at higher levels than hospital-sponsored networks

A recent study showed that physician-sponsored ACOs achieved greater success in the Medicare Shared Savings Program than hospital-sponsored ACOs. In 2014, 31% of physician-sponsored ACOs met their minimum savings rate while only 22% of hospital-sponsored ACOs met this same rate. Additionally, physician-sponsored ACOs were more likely to advance in quality performance. The study also found that cost savings were more likely to be achieved two years in a row among physician-sponsored ACOs. It is believed that the motivation to reduce healthcare spending is more straightforward and less convoluted among physician-sponsored ACOs than hospital-sponsored ACOs.

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About the Author: Lauren Steckler graduated with her MHA from Virginia Commonwealth University in 2014. She began working with MD Value Care during her administrative residency in 2013 and continued her work over the last three years as ACO Program Coordinator at Envera Health. In her free time, Lauren enjoys raising and training a guide dog for Guiding Eyes for the Blind, as well as traveling, and spending time with her family and friends.