Physician-led ACOs overshadow hospital-led ACOs by a large degree
Ever since the Affordable Care Act, accountable care organizations, also known as ACOs, have become a major player in payment and delivery reform, making it an important component of this act.
We highlight the main findings when it comes to ACOs. These are:
- Physician-led accountable care organizations
- Hospital-led accountable care organizations
Even though the two structures are distinct on different levels, recent data proved that physician-led accountable care organizations in the Medicare Shared Savings Program (MSSP) which is a program that followed its goal of allowing coordinated care to optimize outcomes and reduce costs, have been contributing to significant savings compared to hospital-led accountable care organizations.
The Avalere analyst reported that MSSP ACOs keep accomplishing better savings the longer they are included in the program. For instance, 548 MSSP ACOs succeeded to offer care services to over 10 million beneficiaries, reducing Medicare spending by $739 million. The Medicare Shared Savings Program continues to be the largest payment model, focused on one goal: Transitioning Medicare from the fee-for-service payment method into a payment based on the value provided.
On an attempt by the CMS to classify the ACOs as physician-led or hospital-led, an analysis revealed that physician-led ACOs out performed their counterparts.
On average, the physician-led ACOs recorded revenues that were almost 7 times the amount of Medicare savings per beneficiary, compared to hospital-led ACOs.
The reason behind this large margin can be explained by the financial incentives, as the drive to decrease hospital spending was greater for ACOs that were not making high revenues from hospital admissions. Ultimately, CMS is expecting from ACOs to increase their savings for Medicare to reach $2.9 billion over 10 years, so long as they are part of the MSSP.
One of the most challenging tasks of reporting the ACO measures is that a large amount of abstraction needs to be done in a short period of time. Seven weeks of down time from critical staff for this major project can lead to deficiencies and backlogs in other departments. This is where HIA can alleviate this burden. We have qualified staff to ensure your abstracting will be completed and verified to meet these deadlines while allowing your staff to remain productive.
