- Provider groups participating in the Medicare Shared Savings Program (MSSP) reduced spending by 1.4% in 2013, compared with a control group of non-accountable care organizations, a study in the New England Journal of Medicine shows.
- In addition to modest savings, organizations in the MSSP were able to maintain or improve certain quality of patient care performance measures.
- The savings offer evidence ACOs, of which the MSSP is the largest, can enhance care while lowering costs. However, early gains from the MSSP may not predict long-term savings with different types of organizations.
The first 220 ACOs entered the MSSP in 2012 and early 2013. Since then the program has grown to more than 430 participants. Those that joined the program in 2012 reduced spending by $238 million, but those that joined in 2013 saw no savings during their first year in the program.
Further, since the CMS paid ACOs in the 2012 cohort $244 million in shared bonuses, the lowered spending wasn’t really a savings for Medicare.
The study, by researchers at Harvard Medical School, also suggested savings were substantially greater for independent primary care groups than for participants that were integrated with hospitals due to stronger incentives to lower inpatient and hospital outpatient spending — i.e., their shared savings bonuses aren’t offset by profits from reduced hospital care.
Savings were generally lower for ACOs whose baseline spending was above local averages, suggesting the more opportunities groups have to cut spending, the easier it is to do so.