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POM ACO Medicare Shared Savings Program Performance Year 2015 Quality and Financial Results

The Centers for Medicare & Medicaid Services (CMS) recently announced the 2015 performance year results for the Medicare Shared Savings Program and the Pioneer Accountable Care Organization Model that show physicians, hospitals and health care providers participating in Accountable Care Organizations continue to make significant improvements in the quality of care for Medicare beneficiaries, while achieving cost savings.

In 2015, Medicare Accountable Care Organizations had combined total program savings of $466 million, which includes all Accountable Care Organizations’ experiences, for 392 Medicare Shared Savings Program participants and 12 Pioneer Accountable Care Organization Model participants. The results show that more Accountable Care Organizations shared savings in 2015 compared to 2014, and those with more experience tend to perform better over time.

Medicare ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO exceeds quality and financial thresholds – demonstrating achievement of high-quality care and wiser spending of health care dollars – it is able to share in the savings generated for Medicare.

In addition to those ACOs that shared savings, some ACOs had assigned beneficiary expenditures that were either greater than or less than their updated benchmark, but that fell within their minimum savings rate corridor. This means that though they may have generated savings for Medicare, they did not earn a performance payment.  

“On behalf of the 135,000 Michigan seniors with traditional Medicare coverage who rely on POM ACO’s participating providers for their care, we’re proud to report that our 5,200 physicians have achieved an extremely high rate of quality during 2015, hitting virtually all benchmarks set by CMS and improving on our previous year’s performance with a score of 98.6 out of 100,” says Tim Peterson, M.D., POM ACO executive and an assistant professor of emergency medicine at the U-M Medical School.

“At the same time, on behalf of the taxpayers who fund Medicare, we’re proud to have achieved a 1.4 percent savings in the cost of care, which means nearly $18 million less in spending by Medicare. That puts our three-year total at more than $50 million," he adds. "As one of the nation’s largest MSSP ACOs, we are meaningfully improving the way we provide care.”

 

Additional Resources

Visit the Medicare Shared Savings Program News and Updates webpage to access the CMS press release and fact sheet, the link to the Performance Year 2015 results file, and to learn more about the program.

To learn more about POM ACO, visit www.pom-aco.com

 

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