Recent counts of the number of accountable care organizations in the Medicare Shared Savings Program show 27 ACOs have discreetly left the program, according to a Leavitt Partners analysis.
Participation shot up to 432 ACOs, when 89 joined the program in January, but recent CMS data showed just 405 participants, according to the report. Yet interest in value-based programs has never been greater — Earlier this year, 20 major health systems and payers pledged to move 75 percent of their businesses to value-based arrangements by 2020.
To determine why ACOs were disappearing, Leavitt Partners conducted research and was able to pinpoint 19 of the 27 missing organizations. Here are four things to know about seemingly declining interest in the program, based on findings from Leavitt Partners.
1. Most ACOs "left" the program through mergers. These mergers occurred in 13 of the organizations. Many joined forces because they could not meet the 5,000 minimum beneficiary requirement, or because the ACOs did not have sufficient infrastructure to support the program, according to the report.
2. Mergers occurred between ACOs and within ACOs. While some of the mergers occurred between distinct ACOs, others occurred between separate ACOs that were operated by a single organization, according to the report. Some organizations created multiple ACOs through different rounds of the program and are now consolidating them.
3. Six ACOs dropped out. Some partnerships were unsuccessful, according to Leavitt Partners research, while others were unable to meet goals.
4. Most of the drop-outs are still pursuing value-based care. One has entirely dissolved, but the five others are looking into other options. One plans to rejoin the program with a different partner and others are working with commercial payers. Physicians of the dissolved ACO have joined other programs, according to the report.
Leavitt Partners was unable to contact the remaining eight missing ACOs to determine their fate.
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