We draw on data from a convenience sample of 16 ACOs
located in 12 states that involved contracts between an insurance plan and groups of primary care physicians (i.
In new metrics captured by the 2017 ACO
survey, one-third of responding ACOs
include behavioral health providers, and 26 percent of responding ACOs
cover more than 100,000 lives.
Today, more than 800 ACOs
cover an estimated 28 million Americans, a figure that some expect to quadruple over the next five years.
The agency noted that another 83 ACOs
in the Shared Savings Program and two Pioneer ACOs
generated savings in 2015 but did not qualify for bonus payments.
Performance measurement as conceived under program models simply does not occur frequently enough to afford ACOs
actionable insight into areas where improvement is needed.
She called for the government to assure hospitals they can be in ACOs
without suffering from "the catastrophic loss of their tax-exempt status.
really the health care delivery sea change that the world was promised by PPACA, or are they a flash in the pan?
In December 2014, CMS published a Notice of Proposed Rulemaking governing CMS ACOs
that looked for reinsurance "told us that it is difficult to obtain reinsurance, in part, because of insurers' lack of experience with the shared savings program and the ACO
model, and because shared savings program ACOs
take on performance-based risk rather than insurance risk," officials say.
18 per ACO
beneficiary per month--about $105 million less in cost increases incurred by the Pioneer ACOs
-- federally chartered networks of doctors and hospitals that share responsibility for patient care, starting with seniors -- were created as a tool for slowing Medicare spending.
Farber notes that the key differences are that ACOs
are led by providers, not insurance companies, and that ACOs
take a proactive approach to care coordination.