1/ 2017 #MSSP#ACO Results!
ACOs have scaled rapidly across the country!
In aggregate, the 472 ACOs were accountable for nearly 9 million Medicare beneficiaries and $95 Billion- that's a quarter of all fee for service, and almost half of the entire Medicare Advantage market.
2/ If you add up all the actual costs versus benchmarks, these 472 ACOs were collectively $1.1B under their benchmarks (more on whether that's the right counterfactual later).
Medicare shared $780 million in payments with the ACOs, netting the taxpayer $313M
There's lots of evidence that the benchmark under-estimates the savings produced. @JMichaelMcW et al have shown convincingly that a true "difference in difference" approach would show substantially higher net impact.
The green eyeshades folks at CMS OACT said add 60%
Q: Do "low-revenue" ACOs have to enter "Enhanced" track if they have prior experience?
A: No, a low-revenue ACO that is inexperienced with risk can be in the BASIC glide path for agreement period 1 and Level E for their second agreement. More nuanced if experienced with risk
Q: Do percentage regional benchmarks apply to new start ACOs? What does percentage benchmark mean?
A: Regional benchmarks will now start in agreement period 1 (35% for efficient, 25% for inefficient). Independent practices tend to be more regionally efficient! @HRDahlman
So right off the bat we are talking about a July 1, 2019 start where existing ACOs would extend their current contracts six months and new entrants wouldn't start till July 1. This is disruptive hopefully they left the door open to a Jan 1 start.
Very substantial changes as we thought there would be with the new administration and a long time in coming for the rule. The reg text changes themselves run 78 pages