10 things to know about the 89 new MSSP ACOs

CMS released a list Monday of 89 new Medicare Shared Savings Program accountable care organizations that will begin participating Jan. 1, 2015.

Here are 10 things to know about these MSSP ACOs, based on information from CMS and a Leavitt Partners Analysis:

1. The new additions bring the total number of MSSP ACOs to 405 and the total number of Medicare ACOs to 424, including 19 Pioneer ACOs. The year's new cohort is slightly smaller than those in previous years. CMS added 123 ACOs in 2014 and 106 in 2013.

2. Together, the 89 new ACOs' service area spans 40 states. Fifty-three of the ACOs serve just one state and 23 cover two or more. Physicians Accountable Care Organization Solutions covers the largest service area of the new ACOs, with eight states — California, Massachusetts, Pennsylvania, Texas, Utah, West Virginia, Connecticut and Iowa.

3. Most states and Puerto Rico now offer ACO programs. Alaska and Hawaii are the only two states without any ACOs. In the new group of entrants, eight other states did not add ACOs. These states include Montana, Nevada, Colorado, Wyoming, Nebraska, Minnesota, Maine and Vermont.

4. With the new entrants, Medicare ACOs will now cover 7.8 million Americans, which is a more than 40 percent increase from the 5.5 million covered by Medicare ACOs.

5. The 89 new ACOs will add 23,000 healthcare providers to accountable care initiatives. In 2014, existing MSSP ACOs also added 17,000 providers to their networks.

6. The states that added the most ACOs in this group of entrants include Illinois (nine new ACOs), Indiana (nine), Pennsylvania (10) and New York (10).

7. The states with the highest total Medicare ACOs overall include Florida (49), California (35), New York (35), Texas (34) and Illinois (26).

8. The Medicare Shared Savings Program and Pioneer ACOs generated a total of $417 million in cost savings. In fiscal year 2014, Medicare spending per beneficiary was flat in nominal dollars, according to CMS. Previously, in the last four years, spending per beneficiary was increasing at a rate 2 percent less than growth in GDP per capita. Some degree of the slowed growth can be attributed to ACOs, according to CMS.  

9. ACOs can share in savings when they meet specific quality metrics, including patient ratings of provider communication, patient ratings of physicians and blood pressure screening compliance. MSSP ACOs are showing improvement in most of these measures, according to CMS. These organizations have reported higher average performance rates on 30 of 33 metrics, as compared to group practices, which increased average performance on only 17 out of 22 metrics, according to CMS.

10. Notably, Cleveland Clinic, Boston Medical Center, CHI St. Luke's Health in Houston, Lehigh Valley Health Network in Allentown, Pa., and UMass Memorial Health Care in Worcester added ACOs in this round of entrants. Several health systems with existing commercial programs added Medicare ACOs as well. These groups include Livonia, Mich.-based TrinityHealth, York, Pa.-based WellSpan, Falls Church, Va.-based Inova Health System and Sisters of Charity of Leavenworth in Kansas. Imperium and Orange Health sponsored Medicare ACOs again in this group.

Click here for the full list of the 89 newest ACOs.  

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