About a quarter of the ACOs in the MSSP program earned a total of $341 million in payouts. Among them is Delaware Valley Accountable Care Organization, whose CEO shares tips for success.
Quality and financial performance data are in for the accountable care organizations in the Centers for Medicare & Medicaid Services' Pioneer and Medicare Shared Savings Programs, and the results are mixed.
But the spotlight is on the payouts: Eleven of the 20 Pioneer ACOs qualified for performance payments totaling $82 million, and 92 of the 333 MSSP ACOs earned payouts of $341 million.
Established as part of the Patient Protection and Affordable Care Act, the MSSP rewards ACOs that meet certain performance standards on quality and patient satisfaction. It's part of CMS's ongoing efforts to incent healthcare organizations to provide better care coordination for individuals and populations, improve patient outcomes, reduce unnecessary costs, and slow the rate of growth for expenditures.
ACO Model is 'Framework for Collaboration'
While the majority of ACOs in the MSSP did not achieve the thresholds required to receive a shared savings payment, roughly one quarter of them did. Among those is the Delaware Valley Accountable Care Organization, which is based in Villanova, PA, and jointly owned by Main Line Health, Jefferson University and Hospitals, Holy Redeemer Health System, Doylestown Health, and Magee Rehabilitation Hospital.
DVACO president and chief executive officer Katherine Schneider, MD, says the organization provides an important framework for collaboration among the owners that is necessary for success in a value-based reimbursement environment.
Katherine Schneider, MD
It gives providers, physicians, and everyone across the continuum a system and an opportunity to collaborate in a legal fashion that doesn't require everyone to merge or be employed by a health system," Schneider says.
"We are a new breed of Super ACO that gives [the owners] an economy of scale and a regional market presence. It's a good structure to be able to do that, particularly for Medicare fee-for-service where there has not been any way to approach that market. And for most markets, Medicare beneficiaries are a substantial portion of the market share."
A Good First Year
DVACO has been focused on enhancing care coordination, care transformation, and data informatics for its joint partners. And while Schneider says it's difficult to know exactly why its five equity owners were successful in driving down costs last year, she cites decreased admissions as the most likely cause.