American patients eager for proof that healthcare providers are invested in treating their conditions as thoroughly and accurately as possible should be encouraged by a recent announcement from the Centers for Medicare and Medicaid Services.
More than 100 new organizations joined Medicare Accountable Care Organizations (ACOs) — programs which are built to incentivize providers for the quality of their care — according to CMS. The pay-for-performance pillar upon which the ACO model rests contrasts the fee-for-service model that formerly dominated the American healthcare landscape.
“We are moving Medicare and the entire health care system toward paying providers based on the quality, rather than the quantity of care they give patients,” Sylvia Burwell, HHS director, said in a release.
Patients aren’t alone in benefitting from providers’ participation in ACOs. A total of 333 members of the Medicare Shared Savings Program, Pioneer ACO program and other ACO groups reported a sum of $411 million saved in 2014. The Pioneer ACO model was remarkably financially efficient that year, as the 20 Pioneer ACOs combined to save $120 million in their third performance year. That savings figure increased from $88 million in year one to $96 million in year two, a progression that suggests the ACO model becomes more effective and profitable as healthcare providers gain more experience operating under its guidance.
The Department of Health and Human Services was behind a few decisions that prodded U.S. providers to consider their ACO options, including its creation of the Next Generation ACO Model. Healthcare organizations that commit to be next generation ACOs are essentially taking their promise to offer improved patient care one step further. Next generation ACO participants will take on more financial risk than members of other ACOs, but they’ll also be in line to pocket more of any resulting shared savings payments.
The expanded financial responsibility that comes with joining an ACO hasn’t discouraged health plans from joining up, according to a recent survey done by HealthEdge. The survey results showed that 80% of health plans that follow Medicare are committed to value-based payment models, up from 50% that said the same in 2011.