October 30, 2020

Volume X, Number 304

Advertisement

October 29, 2020

Subscribe to Latest Legal News and Analysis

October 28, 2020

Subscribe to Latest Legal News and Analysis

October 27, 2020

Subscribe to Latest Legal News and Analysis

Centers for Medicare and Medicaid Services (CMS) Report Shows Some Medicare Cost Savings Through ACO Model

A report published last week by the U.S. Centers for Medicare and Medicaid Services (CMS) demonstrated, in the words of CMS, “encouraging results” in the reduction of healthcare costs to Medicare and improvement in the quality of care for over 5 million Medicare beneficiaries under the Affordable Care Act (ACA).

Under the ACA, the Department of Health and Human Services runs two different accountable care organization (ACO) programs. According to the report, in the larger of the two ACO programs, 54 of the 114 ACOs reached their goal of lower than expected expenditures. However, only 29 of the ACOs actually had savings large enough to share with their providers, representing just 25% of the 114 ACOs in the program. Although this particular ACO program only produced $128 million in “net savings,” the report states that the “preliminary data” showed that the Medicare ACOs generated $380 million in overall savings for the Medicare trust program when comparing years 2012 to 2013.

Unfortunately, CMS declined to provide any type of context with regards to the savings, such as which hospitals were successful, the amount of the investment made by the participants in the coordination of care, and/or how the savings compared to expectations. This type of information would be valuable to any provider that is considering forming or joining an ACO.

The data contained in the report is preliminary in nature, and represents only one year’s worth of data. It will be important to see if the trend continues overall, whether the same networks are able to maintain their savings from year to year, and whether additional detail will be provided regarding participant investment.

© Copyright 2020 Dickinson Wright PLLCNational Law Review, Volume IV, Number 36
Advertisement

TRENDING LEGAL ANALYSIS

Advertisement
Advertisement

About this Author

2018 Go To Thought Leader AwardHospitals, medical professionals, insurance organizations and others in the healthcare industry face a number of industry-specific regulatory and compliance issues. Dickinson Wright’s interdisciplinary healthcare practice group has the expertise and experience to provide sophisticated, cost-effective legal services to a broad range...

248-433-7234
Advertisement
Advertisement