Hospital-led ACOs perform worse than those led by physicians, study finds

Physician-led ACOs saved Medicare $256.4 million in 2015, but hospital-led ACOs actually cost the program money that same year, according to a study published in The New England Journal of Medicine.

The study, led by researchers from the Department of Health Care Policy at Boston-based Harvard Medical School, analyzed Medicare claims from 2009 through 2015. They compared changes in Medicare spending for patients in physician-led versus hospital-led ACOs before and after the organizations entered the Medicare Shared Savings Program.

Researchers found in physician-group ACOs, MSSP participation was linked with reducing Medicare spending. The longer physician-led ACOs participated in the program, the more significant the savings. By 2015, physician-led ACOs that entered the program in 2012 saw $474 in savings per Medicare beneficiary, compared to $342 for those entering in 2013 and $156 for those entering in 2014.

Comparatively, hospital-led ACOs that entered the program in 2012 only saw $169 in savings per Medicare beneficiary, which declined to $18 for the 2013 group and $88 for those entering in 2014. While spending reductions in physician-led ACOs led to $256.4 million in net savings in 2015, spending reductions in hospital-led ACOs were offset by bonus payments, costing the program money.   

"After three years of the MSSP, participation in shared-savings contracts by physician groups was associated with savings for Medicare that grew over the study period, whereas hospital-integrated ACOs did not produce savings (on average) during the same period," the researchers concluded.

For the full study, click here.

More articles on ACOs:
Medicare is driving ACO growth: 4 report findings
10 best, worst performing MSSP ACOs by shared savings
Next Generation ACOs performing well, but health IT challenges may hinder their success

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