On December 23, 2013, the Centers for Medicare and Medicaid Services announced 123 new Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). This represents the fourth round of MSSP participants, which, coupled with the Pioneer ACOs, brings the number of Medicare ACOs to 366. Some of these organizations were already known to be ACOs, including those that transferred from the Pioneer ACO program, but many were new to accountable care, bringing the total number of public and private ACOs to 606.
With continued government support of ACOs and considerable growth in the number of organizations becoming ACOs, the prospect of ACOs becoming a dominant model in care delivery seems very real. In this post I will evaluate how the accountable care movement has grown and suggest what industry observers should look for in 2014.
Overview of Accountable Care Organizations
An accountable care organization, at its most basic level, is a group of health care providers that accept responsibility to care for the health needs of a defined population while meeting predetermined quality benchmarks. The specific goals of ACOs are to improve quality outcomes, improve the experience of care, and lower costs. Without conveying all the details of what that definition includes, it is important to recognize that the definition is relatively broad; it includes multiple types of organizations operating under many different payment arrangements. While the MSSP is the most publicized incarnation of ACOs, many other public and private models exist, with many different approaches to achieving the common goals.
ACO Growth
Since the MSSP round 3 participants began in January 2013, nearly 200 new public and private ACOs have been formed across the country (Chart 1). During that time, physician groups have become the primary sponsor of ACOs, though other organizations, such as non-profit community organizations and practice management companies, have begun to more actively sponsor ACOs (Chart 2).
Date: January 29th, 2014