Total spending grew significantly less for beneficiaries aligned with Pioneer Accountable Care Organizations in 2012 and 2013, compared to the spending increase for comparable fee-for-service beneficiaries, according to a study published in JAMA.
Researchers compared shared savings data for beneficiary populations in the 32 Pioneer ACOs, including the nine ACOs that dropped out of the program in 2013, with data from similar populations of beneficiaries who were alignment-eligible, but not attributed to a Medicare ACO in 2012 and 2013.
The results showed total spending for Pioneer ACO beneficiaries in 2012 increased approximately $35.62 per-beneficiary-per-month less than the comparison populations. In 2013, the Pioneer population's spending increased about $11.18 PBPM less than the non-ACO population.
Together, Pioneer ACOs achieved a $385 million reduction in increased spending in 2012 and 2013, according to the report. A large portion of this reduction was derived from inpatient care, which increased $14.40 PBPM less in 2012 and $6.46 PBPM less in 2013 than the non-ACO population.
The authors speculate that reductions in spending growth were greater in the first year than in the second for several possible reasons. It may have been difficult to sustain large decreases due to physician turnover, they wrote. Another factor may be spillover in ACO markets, meaning physicians may carry over ACO practice patterns to other non-ACO Medicare patients in the same market.
Another recent study estimated the reduction in spending growth in 2012 to be about $10 PBPM. Results are consistent yet magnified in the JAMA study, likely due to the methodology for selecting beneficiary and comparison populations, according to the report.
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