CMS’ Medicare accountable care organizations, designed to trim the fat from healthcare programs with quality and cost incentives, may actually cost Medicare more money than they save, according to a recent report from Kaiser Health News.
Here are five key takeaways from the report.
1. Many ACOs are dragging. Nearly half — 45 percent — cost the government money, so much so that after paying out shared savings to successful ACOs, the Medicare trust fund actually lost $3 million last year, according to KHN.
2. Current results fall short of 2011 projections that ACOs would generate between $10 million and $320 million in savings in 2014 for the government, according to the report.
3. The primary issue seems to be that participating organizations are too risk-averse, and the program may be too nurturing, KHN reported. ACOs can participate up to six years without taking on risk, and many are taking their time. According to KHN, only 7 percent of ACOs participated in the high-risk, high-reward track last year.
4. While 197 ACOS saved Medicare money and 97 earned bonuses, only three ACOs had to pay back losses last year, according to the report. However, the program will likely find it difficult to force risk adoption, because doing so could force ACOs to leave the program.
5. Nonetheless, CMS remains optimistic, and there is no doubt the model has been successful in some regards: Participating ACOs have improved the quality of care and many have produced millions of dollars in shared savings. CMS actuaries have reported that markets with ACOs have better Medicare spending trends than those without, according to the report.
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