Two years ago the Affordable Care Act brought about the beginning of ACO’s (accountable care organizations). These organizations were created to bring quality of care into play for patients and to reward the best care providers with financial incentives. CMS wanted to prove the value of these ACO’s and so they identified 32 healthcare groups and invited them to be part of the "Pioneer" program. These programs are at full risk for all expenses for their patients, but can realize significant shared savings if they can maintain health and customer service goals, and these rewards can be in the millions of dollars.
Now that the first two years of the program have been completed, CMS has released information on how well the idea of ACO’s is working.
Of the 32 original pioneer participants, nine dropped out after the first year and another four have dropped out for this year citing increased costs of care as a reason. While these plans had losses in the first year of as much as 9.5 million dollars, others were able to realize incentives of over 12 million dollars and are still participating in the program. To see a complete review of these plans, use this link to download the PDF of the ACO Performance Results.
This does not mean that ACO’s are failing: of those that dropped out, seven joined Medicare’s less risky ACO option, the Shared Savings Program and, in addition, CMS has added another 340 programs to the Shared Savings Program. These shared savings participants are delivering good ratings on the 33 graded areas that they are required to report on. Learn about these measures by checking out this week’s Tool for Your Practice. To learn more about what an ACO is and the different types of ACO’s, just use this link to the CMS site.
With a day packed full of education, motivational tools, one-on-one sessions, and workshops, the TCOYD health fair is a great way to get your patients to take better care of their health and themselves. TCOYD.com
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Dave Joffe, Editor-in-chief