New data from released by the Centers for Medicare & Medicaid Services (CMS) on Thursday shows accountable care organizations (ACOs) generated hundreds of millions in savings last year, reigniting the debate around the agency’s proposal to push ACOs into two-sided risk models.
All told, 472 ACOs caring from 9 million Medicare beneficiaries recorded $1.1 billion in gross savings in 2017. After accounting for $780 million in shared savings payments, ACOs in the Medicare Shared Savings Program saved $314 million, according to data released by CMS.
Track 1 ACOs, which do not bear any financial risk but share in any savings generated, made up the bulk of the savings, accounting for $291 million in net savings. Those ACOs also account for the vast majority of ACOs in the program, covering more than 8 million beneficiaries.
For the National Association of ACOs (NAACOs), those number reinforced the need to give ACOs more time to transition from a one-sided risk model to a two-sided approach.
“These recent results show that ACOs have turned the corner and this evidence dispels confusion about ACO performance," NAACOS President and CEO Clif Gaus said in a statement. "The hard work of ACOs is paying off—for patients, providers and for the Medicare Trust Fund, and it’s essential we strengthen this program for the future.”
Granted there are big differences in the number of participants in each track, look at how much more money one-sided risk ACOs saved Medicare compared to the two-sided risk ACOs. Yet CMS wants to curtail the one-side track. https://t.co/MTycKwvxeq pic.twitter.com/yfZGxVlPY9— David Pittman (@David_Pittman) August 30, 2018
Gaus used the newly released data to criticize CMS’ proposed rule that would shorten the path to two-sided risk to two years and cut shared savings in half. A NAACOS survey earlier this year showed most Track 1 ACOs would leave the program if asked to take on more risk.
“The double whammy of greater risk for less reward is like putting up a ‘Stop’ sign on the road to value-based care,” he said.
CMS Administrator Seema Verma has previously said the program is losing money on Track 1 ACOs. Earlier this week she doubled-down on two-sided risk models following a new report on Next Generation ACOs reduced Medicare spending by $62 million.
Obama’s former health IT lead turned ACO guru Farzad Mostashari, M.D., took to Twitter to say he wasn’t backing off his support for two-sided risk models to “weed out ACO squatters.” But the CEO of Aledade said CMS benchmarks actually underestimate the amount of savings generated by ACOs and the true number could be closer to $1 billion.
6/ Lemme say that again....— Farzad Mostashari (@Farzad_MD) August 30, 2018
ACOs saved Medicare over a Billion dollars in 2017.
Cheaper than FFS, cheaper than MA.
And they did it without cutting payments to doctors or narrow networks
And they did it with higher patient quality.
That's called delivering what was promised
Exactly how the final rule plays out remains to be seen, but the industry continues to draw dividing lines over the push to take on more risk.