On
the
heels
of
several
years
of
declining
or
flat
accountable
care
organization
(ACO)
growth
in
the
Medicare
Shared
Savings
Program
(MSSP),
2022
only
saw
a
modest
increase
in
participation,
with
483
ACOs
partaking.
The
current
numbers
do
not
bode
well
in
terms
of
meeting
the
Biden
administration’s
goal
of
having
every
traditional
Medicare
patient
in
an
accountable
care
model
by
2030.
Of
note,
both
levels
of
ACOs
in
the
program
and
patients
in
ACOs
remain
lower
than
in
2020.
Currently
almost
20%
of
Medicare
patients
are
cared
for
by
ACOs.
Since
2012,
ACOs
have
saved
Medicare
$4.7
billion
in
net
savings
and
$13.3
in
gross
savings,
according
to
a
news
release
from
The
National
Association
of
Accountable
Care
Organizations
(NAACOS).
The
group
found
the
Centers
for
Medicare
and
Medicaid
Services
data
on
the
current
number
of
ACOs
participating
in
the
MSSP
in
2022
disappointing.
“NAACOS
is
waiting
to
see
what
participation
is
like
in
the
new
Direct
Contracting
Model,
another
accountable
care
model.
Hopefully,
that
will
account
for
some
of
the
lack
of
growth
in
the
Shared
Savings
Program,”
Clif
Gaus,
president
and
CEO
of
the
National
Association
of
ACOs
(NAACOS)
said
in
the
news
release.
“With
Medicare
spending
continuing
to
rise
to
out-of-control
levels
and
ACOs
proving
they
can
effectively
increase
quality
and
lower
spending,
more
focus
needs
to
be
on
increasing
the
size
of
ACO
programs
in
traditional
Medicare,
which
needs
to
happen
at
levels
much
greater
than
what
we’ve
seen
today.”
ACOs
decrease
Medicare
expenses
by
1%-2%
each
year,
cumulating
to
billions
over
multiple
years.
To
incentivize
new
ACOs
to
join
and
also
keep
current
ones,
NAACOS
suggested
several
actions,
from
raising
shared
savings
rates
for
ACO,
giving
additional
time
prior
to
requiring
them
taking
on
risk,
adjusting
quality
reporting
requirements,
alleviating
administrative
burdens,
solving
top
benchmarking
and
risk
adjustment
issues,
and
allowing
more
up
to
date
and
comprehensive
data.
The
46
new
ACOs
so
far
in
2022
are
not
all
entirely
new.
Among
them,
18
previously
participated
in
Next
Generation
ACOs.
Each
year
there
are
ACOs
that
split
into
several
ACOs,
merge
with
other
ACOs,
drop
out
of
the
program.
.
“When
considering
former
Next
Generation
ACOs
who
moved
into
MSSP
and
the
fact
that
there
was
no
opportunity
to
join
the
model
in
2021,
you
could
consider
this
a
shrinking
of
this
important
ACO
model.
Today
shouldn’t
be
celebrated
but
instead
should
be
a
call
to
action
for
policymakers
to
correct
this
trend
and
address
incentives
to
spur
participation
in
a
voluntary
program
that
has
repeatedly
yielded
savings
and
provides
high
quality
care,”
Gaus
said
in
the
news
release.
The
2022
participation
data
yielded
several
other
significant
details.
First,
those
483
ACOs
are
caring
for
11
million
beneficiaries,
landing
ACOs
the
distinction
of
Medicare’s
most
substantial
alternative
payment
model.
Second,
of
the
current
ACOs,
41%
have
one-sided
risk
while
59%
have
double-sided
risk.
Those
with
double-sided
risk
must
pay
money
back
or
penalties
to
CMS
if
spending
goes
above
the
pre-set
spending
total
or
benchmark.
Those
with
one-sided
risk
do
not
pay
penalties
if
patients’
spending
surpasses
the
benchmarks.
Third,
ACOs
are
comprised
of
almost
529,000
physicians
and
non
physicians.
Lastly,
over
1,300
hospitals
participate
in
ACOs,
according
to
the
news
release.
Despite
the
lower
enrollment
numbers,
ACOs
seem
to
yield
satisfied
patients
and
provide
quality
care,
according
to
the
news
release.
Photo:
Vadzim
Kushniarou,
Getty
Images;
Chart:
NAACOS