decisionhealth Newsletters, Part B News - 2021 Issue 9 (September)
Shared Savings slump? Dip in members, more competition signal change in ACO world
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Article Overview
This article examines recent changes in CMS’s Medicare Shared Savings Program for accountable care organizations, including participation trends, beneficiary counts, performance results, and the broader competitive environment among value-based care models. It is relevant to providers, ACO leaders, and health care administrators tracking CMS initiatives, measurement changes, and policy developments that may influence program participation and future strategy.
Why This Topic Matters
The piece helps readers understand why a widely used Medicare ACO model may be experiencing declining participation even while producing savings, and how CMS policy changes, measurement requirements, and competing models could affect future adoption.
Article Sections
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Signs of a slowdown
Covers recent participation trends, beneficiary counts, and possible factors affecting changes in Shared Savings enrollment.
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The OG ACOs
Summarizes the history of Medicare Shared Savings and related CMS ACO models that shaped the current value-based care landscape.
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Too much competition?
Discusses competing ACO and alternative payment models, along with concerns about overlap, benchmarking, and participant movement between programs.
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A hidden advantage
Reviews beneficiary assignment approaches and the influence of Medicare Advantage on ACO participation and growth.
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The ‘staggering impact’ of eCQMs
Explores reporting and data integration challenges tied to electronic quality measurement requirements and related program concerns.
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Bugs in the system
Describes concerns about benchmarking, risk progression, and other operational issues affecting program participation.
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Forcing Shared Savings to adapt
Highlights proposed legislative and program changes intended to address overlap, risk adjustment, and participation incentives.
What You Will Learn
- How Medicare Shared Savings participation has changed over time
- What CMS data show about ACO performance and savings
- Which broader value-based care trends may be influencing ACO decisions
- What kinds of reporting and benchmarking issues are being discussed by stakeholders
- How policy proposals could affect future ACO program design
Who Should Read This
- Accountable care organization leaders
- Physician group administrators
- Health care compliance and reimbursement professionals
- Medicare and value-based care analysts
- Revenue cycle and population health teams
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