ACOs Moving Ahead

By Sean Cavanaugh, Deputy Administrator and Director, Center for Medicare

Today, we at CMS are excited to announce that 89 new Accountable Care Organizations (ACOs) will be joining the Medicare Shared Savings Program (Shared Savings Program). With today’s announcement, we will have a total of 405 ACOs participating in the Shared Savings Program next year, serving more than 7.2 million beneficiaries. When combined with the Innovation Center’s 19 Pioneer ACOs, we will have a total of 424 ACOs serving over 7.8 million beneficiaries.    

ACOs are one part of this Administration’s vision for improving the coordination and integration of care received by Medicare beneficiaries. ACOs are groups of doctors, hospitals, and other health care providers that work together to give Medicare beneficiaries in Original Medicare (fee-for-service) high quality, coordinated care. ACOs can share in any savings they generate for Medicare, if they meet specified quality targets.

Since ACOs first began participating in the program in early 2012, thousands of health care providers have signed on to participate in the program, working together to provide better care to Medicare’s seniors and people with disabilities. In 2014 alone, existing Shared Savings Program ACOs added almost 17,000 healthcare providers, and the 89 new ACOs will bring approximately 23,000 additional physicians and other providers into the ACO program starting January 1. The growth of this program for providing health care has been continued and consistent since its inception, and we are encouraged by that interest.

We are starting to see promising results. This fall, we released the early findings from the ACOs who started the program in 2012. Shared Savings Program ACOs improved on 30 of the 33 quality measures in the first 2 years, including patients’ ratings of clinicians’ communication, beneficiaries’ rating of their doctors, and screening for high blood pressure. They also outperformed group practices reporting quality on 17 out of 22 measures. We are also seeing promising results on cost savings with combined total program savings of $417 million for the Shared Savings Program and the Pioneer ACO Model.

While we are encouraged by what we have seen so far, we also understand there are opportunities to improve the program to make it stronger. Earlier this month, we published a proposed rule to update the guidelines for the program. We are looking forward to receiving comments from ACOs, beneficiaries, and their advocates, providers, and other stakeholders interested in seeing the ACOs succeed long-term.

ACOs are also just one way that CMS is working to reduce the rate of growth in Medicare spending while improving care. Medicare spending per beneficiary was essentially flat in nominal dollars in fiscal year 2014, and from 2010 to 2014, Medicare spending per beneficiary grew at a rate that was 2 percentage points per year less than growth in GDP per capita. While the recent slow cost growth has multiple causes, our reforms in the Medicare and Medicaid programs are meaningful contributors to these gains and are improving quality as well. Preliminary data for 2013, for example, indicates improvements in patient safety resulted in 50,000 fewer deaths, 1.3 million fewer patient harms, and $12 billion in avoided health care spending. Recent research implies that many of these reforms may be generating savings in the private sector as well.

Ultimately, today’s announcement is about delivering better care, spending dollars more wisely, and having healthier people and communities. ACOs drive progress in the way care is provided by improving the coordination and integration of health care, and improving the health of patients with a priority placed on prevention and wellness. We look forward to continuing this partnership with doctors, hospitals, and other health care providers in increasing value and care coordination across the health system.

For a list of the 89 new ACOs announced today, visit: ?


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