More ACOs taking on downside risk, analysis finds

ACOs participating in the Medicare Shared Savings Program are increasingly moving toward downside financial risk through value-based contracts, according to a Health Affairs blog.

The blog — written by researchers from Washington, D.C.-based Duke University and Leavitt Partners, a healthcare intelligence business — summarizes CMS enrollment data and Torch Insight ACO tracking data. Torch Insight is a healthcare database from Leavitt.

Researchers found only five out of 220 ACOs (2 percent) took downside risk in the first performance year of the MSSP, which began in 2012. That's up to about 30 percent (152 out of 518) today.

As of this quarter, 28 percent of MSSP ACOs (146 out of 518) qualify as an advanced alternative payment model, which requires some downside risk, according to information analyzed in the blog. The other six MSSP ACOs that participate in two-sided risk contracts don't qualify as an advanced APM (through Basic Levels C and D participation options).

The findings come after CMS in December issued a final rule that the agency said redesigned the MSSP to encourage ACOs to move toward risk more quickly. 


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