Emerging quality and savings trends outline challenges and promise of ACO model

By Matt Kuhrt

The early success of Medicare's move toward value-based payment models has generated enough data from accountable care organizations (ACOs) to assist organizations that may want to make the leap and enter Medicare's Shared Savings Program (MSSP), according to a white paper from Leavitt Partners.

In order to get a read on the effectiveness and ultimate viability of transforming an organization into an ACO, Leavitt combined the public performance data provided by the Centers for Medicare & Medicaid Services (CMS) with information from its own proprietary database. As existing ACOs continue to evolve, a coalition of healthcare organizations has urged CMS to encourage greater participation in the MSSP, as FierceHealthFinance has previously reported.

The white paper identified several emerging trends:

  • Geography plays a role. The data exposed a link between increased savings and high-cost markets, as well as a geographic correlation for both quality and savings. On the plus side, the paper noted CMS is already looking to tweak its methodology to account for these imbalances by adjusting ACOs' scores based on costs and expenditures in their regions, rather than by comparing them all against a national standard.
  • Quality and savings metrics don't always coincide. Results indicated ACOs with larger numbers of contracts and those covering more lives generated better results in terms of quality, but failed to result in improved savings. Similarly, ACOs with the highest earnings saw higher quality scores, but that did not necessarily mean more shared savings.
  • When quality and savings metrics do coincide, the results can be impressive. In looking narrowly at the ACOs earning the most in shared savings, Leavitt Partners that "at the top, there appears to be a high correlation between shared savings and high quality," suggesting the possibility that the results will eventually help to identify a subset of high-achieving organizations whose performance could become a template for other organizations.

To learn more:
- see the white paper (.pdf)