Medicare ACOs in New York lost $40M in 2017, report finds

New York ACOs participating in the Medicare Shared Savings Program recorded a $40 million net loss in 2017, or about $75 per beneficiary, according to a report from New York independent research firm United Hospital Fund.

The report, written by Gregory Burke, director of innovation strategies at United Hospital Fund, analyzed 2017 MSSP ACO data from CMS. The data is the most recent year for which CMS data is available.

New York's 32 MSSP ACOs cover roughly 30 percent of all Medicare fee-for-service beneficiaries in the state. Collectively, the ACOs generated $11.5 million in gross savings against their benchmarks in 2017. That's up more than $70 million from each of the two prior years, according to the report.

While 13 ACOs received shared savings in 2017 compared to five in 2016, the top-line figures didn't translate to savings to CMS. The report also questioned how new regulations from CMS that require greater assumption of financial risk by Medicare ACOs will affect future performance.

"As those requirements phase in over the next few years, provider groups currently participating in the 'shared savings only' model will need to evaluate whether they wish to continue in the program," Mr. Burke wrote. "The recent improvement in ACOs' financial performance is encouraging; New York's ACOs appear to be learning how to work more effectively within the mechanics of the MSSP. But the progress has been slow, and the expansion of value-based payment systems similar to those of the MSSP may not quickly solve New York's longstanding problems of cost and quality."

For the full report, click here.

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