The Centers for Medicare and Medicaid Services (CMS) released summary results for Pioneer and Medicare Shared Savings Program (MSSP) ACOs. The Pioneer data reflects performance in year 3 (2014) and MSSP data for Tracks 1 and 2 (2014). Pioneer ACOs improved their quality scores on 28 of 33 measures; MSSPs improved on 27 of 33 measures. 
PIONEER ACOs
  • In 2014, 20 Pioneers and 333 MSSPs generated more than $411 million in net savings, which includes all savings and losses.

  • Pioneer ACOs averaged total model savings of $6.0M per ACO, compared to $4.2M in 2013 and $2.7M in 2012.

  • The mean overall quality score was 87.2%, compared to 85.2% in 2013 and 71.8% in 2012. The most significant improvements over 2014 were medication reconciliation, screening for clinical depression and follow-up plan, and qualification for an electronic health record incentive payment.

MEDICARE SHARED SAVINGS PROGRAM
  • About one-quarter of ACOs (96) saved CMS $806 million below target expenditures, earning MSSPs $341 million in payments. Another 89 achieved savings against their benchmark but did not meet the minimum threshold to earn a payout from CMS.

  • ACOs with more experience were more likely to earn savings.

  • Total net savings to the Medicare Trust Funds was $383 million.

  • CMS said that strong interest in the Shared Savings Program continues and that it will announce new and renewing ACOs at the end of the year.

Our Take: As we saw in Performance Years 1 and 2, savings and quality vary widely among Pioneers. Banner Health and Partners HealthCare led in total savings over benchmark, saving $29.0M and $21.7M, respectively. But by one measure the Michigan Pioneer ACO outperformed the others by a mile, with total savings averaging $1,013 per beneficiary.
Banner Health took home $18.7 million in shared savings, topping the list of Pioneer ACOs than earned shared savings, for about 23% of the $81.5 million paid out. Three ACOs owe CMS a total of $9.1M: Beacon Health ($2.9M), Dartmouth-Hitchcock ACO ($3.6M) and Franciscan Alliance ($2.5M). In fact, this was Franciscan Alliance’s last year reporting as a Pioneer and has since transitioned to the MSSP track.
Bellin-ThedaCare, Beacon Health, Atrius Health, Mount Auburn Cambridge IPA and OSF Healthcare all posted higher than 90% in overall quality. Monarch led all ACOs with the lowest risk standardized all-condition readmission rate, while Banner Health was most effective in reducing unnecessary admissions for COPD and asthma (ACO-9) and heart failure (ACO-10).
Atrius Health, Park Nicollet and Bellin-ThedaCare were standout performers on diabetes and cardiac performance metrics.
We will release MSSP results in a future ActionBrief.

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