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Medicare Shared Savings Program Saved $466 Million in 2015

Pioneer ACOs operating under the Medicare Shared Savings Program have seen steady improvements in quality of care and cost savings.

By Vera Gruessner

The Centers for Medicare and Medicaid Services (CMS) announced last week the quality and financial results of the 2015 Medicare accountable care organizations. According to a press release from CMS, accountable care organizations operating under the Medicare Savings Program better quality care for Medicare beneficiaries as well as gaining financial savings.

Accountable Care Organizations

Among 400 accountable care organizations, a total savings of $466 million was generated in 2015. Out of all of these accountable care organizations, 125 ACOs achieved their quality performance benchmarks and met their cost savings threshold. The results are showing continued improvement since more ACOs are sharing in their cost savings in  2015 as compared to 2014.

“Accountable Care Organization initiatives in Medicare continue to grow and achieve positive results in providing better care and health outcomes while spending taxpayer dollars more wisely,” Dr. Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer, said in a public statement. “CMS continues to work and partner with providers across the country to improve the way healthcare is delivered in the United States.”

Accountable care organizations operating in the Pioneer ACO Model under the Medicare Shared Savings Program show continued improvement among those with more experience.

Pioneer accountable care organizations generated a total surpassing $37 million in 2015. During the four year of operation, nine out of the 12 Pioneer ACOs achieved quality scores above 90 percent, reports CMS.

When comparing the Pioneer ACOs operating within the Medicare Shared Savings Program to their first year of operation, the latest results show that their quality scores grew by more than 21 percent over the last four years.

“The coordinated, physician-led care provided by accountable care organizations resulted in better care for over 7.7 million Medicare beneficiaries while also reducing costs,” CMS Acting Administrator Andy Slavitt said in a press release. “I congratulate these leaders and look forward to significant growth in the program in the coming year.”

The entirety of the Medicare Shared Savings Program has led to a savings of $1.29 billion for Medicare since 2012. A vital part of the program has also led to stronger quality care among Medicare beneficiaries including improved patient ratings, better communication on the part of physicians, and a rise in adherence to electronic medical record use.

Ever since the Patient Protection and Affordable Care Act was passed into law, the Medicare Shared Savings Program brought into operation more than 470 ACOs that have served almost 9 million Medicare beneficiaries. The type of different ACOs that have been established include the Pioneer Accountable Care Organization Model, the Next Generation Accountable Care Organization Model, and the Comprehensive End-Stage Renal Disease Care Model, CMS stated in its release.

Within the Pioneer ACO Model, six out of the eight accountable care organizations that garnered cost savings had reached outside of the minimum cost savings rate threshold, according to a CMS fact sheet.

The quality score among Pioneer ACOs rose to 92.26 percent in 2015 from a rate of 87.2 percent in 2014, which shows steady improvements to quality care among these particular accountable care organizations.

“Shared Savings Program ACOs that reported quality in both 2014 and 2015 improved on 84 percent of the quality measures that were reported in both years,” the CMS fact sheet stated. “The average quality performance improved by over 15 percent between 2014 and 2015 for four measures: screening for risk of future falls, depression screening and follow-up, blood pressure screening and follow-up, and providing pneumonia vaccinations. Over 91 percent of ACOs in a second or third performance year during 2015 increased their overall quality performance score through Quality Improvement Reward points in at least one of four quality measure domains.”

The latest results from CMS showing ongoing cost savings and quality improvements from the Medicare Shared Savings Program seems to point in the direction that this particular healthcare reform has brought benefits for the patient community as well as the overarching goal of the Triple Aim of Healthcare to reduce medical spending.


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