Record-Breaking Savings for ACOs in 2023

ACCOUNTABLE CARE ORGANIZATIONS

By Health Capital Consultants, LLC

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On October 29, 2024, CMS announced Performance Year (PY) 2023 results for accountable care organizations (ACOs) participating its Medicare Shared Savings Program (MSSP). Notably, MSSP ACOs garnered the largest net savings in MSSP’s history – more than $2.1 billion.

This Health Capital Topics article discusses MSSP performance in 2023 and how this may inform value-based care going forward. (Read more…) 

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PHYSICIAN: Pay Cuts in 2025

By Staff Reporters

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Doctors, Facing Another Pay Cut, Call for Permanent Medicare Payment Reform

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. CMS has finalized the calendar year 2025 Medicare Physician Fee Schedule rule that sets payment rates for next year and also outlines new policies focused on primary care, preserved telehealth flexibilities, and a strengthened Medicare Shared Savings Program (MSSP). 

But, provider groups were quick to condemn CMS’ decision to go ahead with the pay cut, which was proposed in the draft rule released in July. In a statement, Bruce Scott, MD, president of the American Medical Association (AMA), pointed out that that while physicians are receiving a 2.8% payment cut next year, medical practice costs for physicians will increase by 3.5% in 2025. After adjusted for inflation, Medicare reimbursement to physicians has decreased 29% since 2001, the AMA says.

Source: Heather Landi, Fierce Healthcare [11/2/24]

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BENEFICIARIES: Assigned to MSSP Accountable Care Organizations [ACOs]

Number of Beneficiaries Assigned to MSSP ACOs, 2012-2013 to 2022

By Charlene Ice

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  1. 2012/2013: 3.2 million
  2. 2014: 4.9 million
  3. 2015: 7.3 million
  4. 2016: 7.7 million
  5. 2017: 9 million
  6. 2018: 10.5 million
  7. 2019: 10.4 million
  8. 2020: 11.2 million
  9. 2021: 10.7 million
  10. 2022: 11 million

Notes: “MSSP” denotes the Medicare Shared Savings Program
Source: Statista, June 20, 2022
Source URL: https://www.statista.com/statistics/1278948/number-of-benefi…

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DICTIONARY: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4
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ACOs: Participation Up in 2024

By Health Capital Consultants, LLC

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On January 29, 2024, the Centers for Medicare and Medicaid Services (CMS) announced that Performance Year 2024 participation increased in their various accountable care organization (ACO) initiatives. Specifically, 50 new ACOs joined the Medicare Shared Savings Program (MSSP), and 71 ACOs renewed their contracts, bringing the total participation in the MSSP to 480 ACOs.

Additionally, 245 organizations chose to continue participation in two other CMS models – the ACO Realizing Equity, Access, and Community Health (REACH) Model and the Kidney Care Choice (KCC) Model.

CITE: https://www.r2library.com/Resource

This Health Capital Topics article reviews the CMS report and implications for CMS’s ACO initiatives. (Read more…) 

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CMS: MSSP ACO Growth 2012-2022

By Staff Reporters

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DEFINITION: An accountable care organization is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation.

CITE: https://www.r2library.com/Resource/Title/0826102549

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See the source image

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CMS MSSP ACO Growth 2012-2022

Performance YearACOsAssigned Beneficiaries
202248311.0 million
202147710.7 million
202051711.2 million
201948710.4 million
201856110.5 million
20174809.0 million
20164337.7 million
20154047.3 million
20143384.9 million
2012+20132203.2 million

Source: CMS 2022 Shared Savings Program Fast Facts – As of January 1, 202

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