How fast will ACOs spread?

Even with providers cheering for the revisions in the Centers for Medicare & Medicaid Services' (CMS) final accountable care organization (ACO) rule, organizations (and the government) may be wondering if the revisions will be enough to capture participants.

With the guidelines released on Oct. 20 about the Medicare Shared Savings Program, hospital association and professional physician groups praised the reduced quality measures as less burdensome and adjusted savings as better motivators to join.

How many and how fast will ACOs spread? CMS estimates 50 to 270 ACOs will sign up to participate, generating a net savings of $940 million during the first four years through Shared Savings, according to a recent report by the Urban Institute and the Robert Wood Johnson Foundation.

However, some are still skeptical the ACO movement will catch on as quickly as intended.

"[T]he reception to CMS' final regulations has been positive, but how many organizations will actually apply to CMS to be ACOs is another question," the Robert Wood Johnson Foundation webpage states.

According to the report, it's unclear if the Shared Savings Program and the earlier Pioneer ACO model are intended to test the ACO concept for large-scale implementation, to see whether it generates sustainable governmental savings, or to move as many providers as possible to ACOs to curb Medicare spending.

As MedPAC has noted, "It would be a mistake to assess the success of the [Shared Savings] program by counting how many ACOs participate in the initial agreement period," according to the report.

For more information:
- read the report summary (.pdf)
- read the full report (.pdf)
- here's the RWJF webpage

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