The Centers for Medicare & Medicaid Services announced yesterday that it has signed on 27 organizations as the first under its Shared Savings Program for accountable care organizations (ACO).
In all, the 27 ACOs in the program operate in 18 states and will serve approximately 375,000 people. CMS noted that in addition to this program, along with the previously announced 32 ACOs in the Pioneer Program and six enrolled in the Physician Group Practice Transition Demonstration, more than 1.1 million beneficiaries are now receiving services through various CMS shared savings care models.
CMS noted that it also has another 150 applications for entrance to the program pending and that it anticipates adding even more healthcare organizations to the program by summer.
"We are encouraged by this strong start and confident that by the end of this year, we will have a robust program in place, benefitting millions of seniors and people with disabilities across the country," said CMS Acting Administrator Marilyn Tavenner, in a press release.
One concern expressed early on by healthcare providers was the anticipated costs associated with establishing an ACO. This was not an issue for many larger health systems, who have the resources and have already been working to redesign their systems toward an ACO model. But for smaller, rural providers, the time and expense was seen as a barrier to participation.
To address these concerns, CMS announced last November the Advance Payment ACO model under which providers could receive advance funding from CMS to help them build and pay for infrastructure needed to support an ACO. Of the 27 organizations named yesterday to the program, five will participate in this advance-funding model. Of the more than 150 pending ACO applications, roughly 50 have also applied for the Advance Payment ACO.
Under the shared savings program, ACOs will need to meet 33 quality measures relating to care coordination and patient safety, use of appropriate preventive health services, improved care for at-risk populations and the patient experience of care – while reducing the costs of care. ACOs that meet the standards will be eligible to share in the program's savings.
While the ACO programs from CMS currently run through the Center for Medicare and Medicaid Innovation (CMMI) and were made possible as a result of the Affordable Care Act, they are not likely to disappear should the Supreme Court see fit to dismantle the law. Many of the organizations named to the program were creating, or had already created, an ACO structure for their organization.
"It's not changing anything for us," Emily Brower, an executive director with Atrius Health, operator of a pioneer ACO in Massachusetts, told Kaiser Health News. "This is a model of care we've been trying to evolve into since before the pioneer program existed. We'll continue making investments, and if the law is overturned, we'll be asking where the return on investment is for us, if not in shared savings."