The Debbie Downers in U.S. healthcare would like nothing more than to declare the premature death of the accountable care organization (ACO) phenomenon. Depending whom one speaks to, ACOs are either too aggressive and ambitious in their aspirations and requirements, or not aggressive and ambitious enough; they are either too rigidly architected to succeed, or not built rigorously enough. And the ACO movement is either moving too fast for its leaders to absorb learnings, or moving far too slowly to make any difference in broadly improving patient outcomes and bend the healthcare cost curve in this country.
But the data unveiled on October 12 by the Centers for Medicare and Medicaid Services (CMS) showed real progress in a number of areas. As Managing Editor Rajiv Leventhal noted in his Oct. 16 article, the results reveled that “61 percent of program participants were able to earn shared savings last year. The federal ACO data from CMS, released without much elaboration, as it often was in the previous administration, disclosed the results of how the 18 ACOs in CMS’ Next Gen ACO model performed in 2016,” Leventhal noted.
“The 2016 Next Gen ACO data,” he continued, “revealed that 11 of 18 participants were able to earn shared savings, while the remaining seven ACOs generated losses outside a minimum loss rate and thus owed shared losses. However, in sum, adding up the 11 ACOs which were able to generate savings ($71 million) and subtracting from the seven ACOs which owed losses ($23 million), the net of all gross savings and losses is about $48.3 million in savings, per the CMS data. And, in aggregate, those ACOs which generated shared savings were rewarded with $58 million in bonus money, while those participants that lost money paid $20 million back in total.”
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