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CMS Announces New ACO Participation and Savings Numbers

January 15, 2020

McDermott+Consulting

In a blog post, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma touted the uptick in participation in two-sided risk arrangements in the redesigned Medicare Shared Savings Program for Accountable Care Organizations (ACOs), which the agency overhauled in 2018. Under the redesigned program, ACOs were encouraged to take on more financial risk in exchange for flexibility in program design. According to the announcement, 192 ACOs will take a risk in 2020, compared to 93 at the start of 2019. ACOs now serve approximately 11.2 million Medicare fee-for-service beneficiaries, up from 10.4 million at the start of 2019. Verma also announced savings results in the Next Generation ACO (NGACO) program, a CMMI model that tests higher levels of risk and additional flexibilities. In 2018, the model’s third performance year, 38 ACOs (76% of participants) achieved shared savings, while 12 ACOs (24% of participants) had losses. In total, CMS estimates that the NGACO model saved the Medicare program more than $184 million in 2018. CMS also published the second evaluation report for the NGACO model, examining the first two performance years (2016 and 2017). The report found a statistically significant reduction in spending under the NGACO model compared to care outside the model.  However, after taking into account the shared savings payments made to ACOs, the report finds the model did not lead to a statistically significant difference in spending for the first two performance years. The NGACO model ends this year and stakeholders have been pushing the agency to use its authority to make the model permanent.

 

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For more information visit the McDermottPlus Payment Innovation Resource Center or contact Mara McDermott at 202-204-1462 or mmcdermott@mcdermottplus.com.

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