Medicare ACOs continue to improve quality of care, generate shared savings

RESEARCH TRIANGLE PARK, N.C. – The Centers for Medicare & Medicaid Services issued 2014 quality and financial performance results showing that more Medicare Accountable Care Organizations (ACOs) continue to generate financial savings while improving the quality of care for Medicare beneficiaries by fostering greater collaboration between doctors, hospitals, and health care providers. 

When an ACO demonstrates that it has achieved high-quality care and effectively reducing spending of health care dollars above certain thresholds, it is able to share in the savings generated for Medicare. In 2014, 20 Pioneer and 333 Shared Savings Program ACOs generated more than $411 million in savings, which includes all ACOs savings and losses. The results also show that ACOs with more experience in the program tend to perform better over time.

Medicare ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO exceeds quality and financial thresholds – demonstrating achievement of high-quality care and wiser spending of health care dollars – it is able to share in the savings generated for Medicare.

RTI International serves as the Program Analysis Contractor for the Medicare Shared Savings Program and Pioneer ACO Model, under contract with CMS. In this role, RTI supports the implementation, operation, refinement, and analysis of the ACO models. 

RTI supported determination of ACO financial and quality performance, including: performing beneficiary assignment and computing ACO benchmark and performance year expenditures; aggregating quality performance data and calculating ACO quality scores; and producing related ACO performance reports.

Visit the Medicare Shared Savings Program News and Updates webpage to access the HHS press release and fact sheet, the link to the Performance Year 2014 results file, and to learn more about the program. RTI's May 2015 Issue Brief on Accountable Care Organizations in Medicare is available here.

A team of doctors and nurses discuss patient care

Highlights

  • The CMS issued 2014 quality and financial performance results showing that more Medicare Accountable Care Organizations continue to generate financial savings while improving the quality of care for Medicare beneficiaries
  • RTI supports the implementation, operation, refinement, and analysis of the ACO models