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Shared from Avalere Health News – August 31, 2016 Pioneer and MSSP ACOs Achieve Modest
Savings / On August 25, the Centers for Medicare & Medicaid Services (CMS) released aggregate and individual financial and quality results from 2015 for Pioneer and Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs). In total, the 12 Pioneer and 392 MSSP ACOs generated program savings of $466 million, while 125 ACOs earned shared savings of $679 million. Notably, the total earned shared savings payment is $256 million more than earned last year. Furthermore, overall quality scores for nine of the 12 Pioneer ACOs were above 90 percent and over 91 percent of MSSP ACOs in a second or third performance year increased their overall quality performance score through Quality Improvement Reward points. Approximately 52 percent of ACOs spent less than their benchmark, but only 31 percent qualified to share in savings. In addition, 188 Track 1 MSSP ACOs spent more than their benchmark, with the average overage equaling $6 million. Although these ACOs do not need to repay CMS, the agency estimates that ACO start-up costs range between $1 and $2 million. In total, in 2015, ACOs spent $1.17 billion more than their benchmark, compared to $707 million more than their benchmark in 2014, which brings into question the long-term sustainability of these ACOs. Why Does It Matter? Looking ahead, two factors will likely drive ACOs' decision to continue participation in the program: the modified benchmark methodology, which incorporates regional spending and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). If the updated benchmark methodology and the Advanced Alternative Payment Model (APM) payment incentives lead to greater ACO participation, then CMS believes MSSP will generate more savings than current projections.
Vivage Senior Living is pleased to be part of Centura Health’s MSSP and BPCI initiatives. Vivage Senior Living is a subscriber to Avalere’s Vantage Care product. 
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