Our Take: 2018 MSSP performance data released by CMS
Oct 07, 2019
CMS last week released 2018 performance results for its Medicare Shared Savings Program (MSSP). This week we’ll review some top-line results.
In a blog post, the biggest news coming from CMS Administrator Seema Verma is that ACOs that took on more risk outperformed those that took on less, and physician-led ACOs outperformed those originating from an IDN. (We haven’t independently confirmed this; we haven’t had enough time with the dataset to say for sure, but the numbers that Verma cited are compelling.)
Specifically, ACOs that took on downside risk — i.e., Track 2, Track 3, and Track 1+ models — had an average reduction in spending relative to projected costs of $96 per beneficiary, compared with $68 for Track 1 ACOs. Physician-led ACOs had an average reduction in spending relative to projected costs of $180 per beneficiary, compared with $27 per beneficiary for hospital-led ACOs.
Our Take: Quality
A glance at the list below shows that physician-led ACOs also stand out as leaders in quality. We looked at the top five performers on five common quality measures, and 85% of the ACOs were physician-led. Note that despite the improved financial performance of those ACOs taking on downside risk, 72% of the ACOs listed below are Track 1 (no downside risk).
Managing poorly controlled diabetic population: Billings Clinic, Rio Grande Valley Health Alliance, Village MD New Hampshire ACO, SERPA-ACO (Neb.), and Great Plains Care Organization (Iowa)
Controlling high blood pressure: Rio Grande Valley Health Alliance, Akira Health of Los Angeles, Coastal Carolina Quality Care, NexCentra Health Partners (N.C.), and USMD Physician Services (Texas – Optum)
Depression remission at 12 months: MHN Partners (Iowa – Mercy), Emerald Coast ACO (Fla.), Keep Well ACO (Mo.), Balance ACO (N.Y.), and Empire ACO (N.Y.)
All-cause, unplanned hospital admissions: CCACO (N.Y.), Physician Health Partners (Colo.), Paradigm ACO (Fla.), Aledade Utah ACO, Intermountain Accountable Care
Patient satisfaction (average of eight patient experience measures): Genesis Physicians Group (Texas), Think ACO (Neb.), Aledade Louisiana ACO, South Texas ACO Clinical Partners, Northern Ohio Medical Specialists
“In 2018, ACOs continued to deliver high-quality care to Medicare beneficiaries, with nearly all ACOs continuing to satisfactorily report quality measures and meet the quality performance standard,” Verma wrote. Further, 93% of eligible ACOs earned improvement reward points, with the most improvement in preventive health measures, according to Verma.
In all, there was $739.4 million in total net savings — the total shared savings less the amount given back to ACOs — more than double the $314 million in net shared savings in 2017. Of note, 205 ACOs (38%) had shared savings, compared with 162 ACOs (34%) in 2017.
Palm Beach Accountable Care Organization was the best financial performer by a mile, achieving $112.5 million in shared savings and earned savings of $50.1 million. Palm Beach Accountable Care Organization also led the pack in 2017, with $63.1 million in shared savings. New York City-based Balance ACO was the runaway winner on a more standardized measure, with $6,913 in shared savings per beneficiary. Balance ACO also topped the list in 2017, with $6,676 in shared savings per beneficiary.
Beacon Health Partners was the worst performer of the group — with $45 million in shared losses — but owed Medicare nothing because of its Track One status. Of the 548 MSSP ACOs in 2018, only 11 ACOs had shared losses, returning a total of $17.6 million to CMS.
Our verdict, so far, on the 2018 data: On the whole, many ACOs continue to improve quality while showing better financial performance. More to come in a future post.
What else you need to know
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