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Analysis

Medicare Shared Savings ACOs Saved $2.6B in 2019

By John Commins  
   September 14, 2020

The savings represents a $940 million increase over the $1.7 billion saved in 2018.

Medicare's Shared Savings Program generated $2.6 billion in savings in 2019, and netted $1.2 billion after paying out bonuses and collected shared loss payments from providers, new data from the Centers for Medicare and Medicaid Services show.

The savings represents a $940 million increase over the $1.7 billion saved in 2018. In the seven years since it began in 2013, MSSP has generated more than $7 billion in savings, CMS data show.

More than 540 accountable care organizations in the MSSP served 11.2 million Medicare beneficiaries in 2019. 

Clif Gaus, president and CEO of the National Association of ACOs, said the new data from 2019 "clearly show that ACOs are helping improve our health system at a time when it’s needed more than ever."

"When we emerge from the ongoing pandemic, we’ll need alternatives to fragmented fee-for-service and better cost-control strategies, which ACOs provide," Gaus said. "There should be no debate that we need to foster the growth of more ACOs so their benefits are delivered to more seniors."

Only 5% of ACOs signed on for CMS's Pathways to Success model during its rollout year in 2019. Gaus said Congress could generate more interest in the new model with better incentives under the Advanced Alternative Payment Models.

CMS also reported that:

  • 92% of eligible ACOs earned quality improvement reward points in 2019. The greatest improvements were in patient safety and care coordination.
     
  • ACOs showed better or comparable on quality metrics when compared with physician group practices.
     
  • ACOs in both shared savings-only models and risk-based models had net savings for Medicare, as did ACOs in low- and high-revenue categories, and ACOs in the legacy MSSP models and the new Pathways to Success model.

CommonSpirit Saves $70 Million

Chicago-based CommonSpirit Health announced that its 16 MSSP ACOs in 21 states and serving 321,000 Medicare beneficiaries kept $37 million of the $70 million they generated in shared savings and also recorded quality scores averaging 94%. 

CommonSpirit said its ACOs reduced short-term inpatient hospital admissions and emergency department visits by 1%, long-term inpatient hospital stays by 21%, and increased primary care services by 2%. In addition, 10 of the 16 CommonSpirit MSSP ACOs generated savings, and 56% received shared savings payments.

"Our ACOs and clinical leaders are an essential driver of this strategy, demonstrating a clear commitment to compassion across the continuum of care by building strong relationships with our patients, proactively supporting their health and wellbeing in their communities, and modeling financial stewardship for sustainability," said Bruce Swartz, CommonSpirit's executive vice president, Physician Enterprise.

“When we emerge from the ongoing pandemic, we’ll need alternatives to fragmented fee-for-service and better cost-control strategies, which ACOs provide.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

In the seven years since it began in 2013, MSSP has generated more than $7 billion in savings.

More than 540 ACOs in the MSSP served 11.2 million Medicare beneficiaries in 2019.

More than 90% of ACOs earned quality improvement reward points in 2019, mostly for patient safety and care coordination.

Only 5% of ACOs signed on for CMS's Pathways to Success model during its rollout year in 2019.


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