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OIG Study Shows ACOs Reduce Costs While Improving Quality

Posted in Accountable Care Organizations, Affordable Care Act, Hospitals and Institutions, Legislation and Public Policy, Medicare and Medicaid, Reimbursement Matters

According to a study report released by the Department of Health and Human Services’ Office of Inspector General (OIG) in late August, accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) demonstrated significant cost savings while scoring higher in quality metrics than the applicable benchmarks. The OIG also released a summary of the report.

The OIG evaluated data from the 9.7 million beneficiaries served by the 428 ACOs participating in the MSSP from 2013-2016. The OIG found that “During that time, most of these ACOs reduced Medicare spending compared to their benchmarks, achieving a net spending reduction of nearly $1 billion. At the same time, ACOs generally improved the quality of care they provided, based on [Centers for Medicare & Medicaid Services] data on quality measures. In the first 3 years, ACOs improved their performance on most (82 percent) of the individual quality measures. ACOs also outperformed fee-for-service providers on most (81 percent) of the quality measures.”

Additionally, the report found that there is a subset of high-performing MSSP ACOs and highlighted a number of features that set these organizations apart, including providing the highest number of primary care visits compared to other ACOs, only including physicians in the ACOs, and serving a larger number of beneficiaries. The report concludes by noting that “While policy changes may be warranted, ACOs showed promise in reducing spending and improving quality,” and that additional information about high-performing ACOs would inform the future direction of alternative payment models, including the MSSP.

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