Saving money while raising the quality of health care has been the central focus of the health care industry — from providers to health insurance carriers — since the arrival of the Patient Protection and Affordable Care Act (PPACA). One of the biggest drivers of both cost savings and increased quality was the implementation of accountable care organizations (ACOs).
Pass?
In August 2015, the Centers for Medicare & Medicaid Services (CMS) released its 2014 financial and quality performance results for its Medicare ACOs. According to CMS, ACOs in its Pioneer ACO Model and Medicare Shared Savings Program (MSSP) generated more than $411 million in total savings in 2014 — which would seem to indicate that ACOs are working, and working well.
Fail?
There's another piece to the puzzle, however. Of the 353 Pioneer and MSSP ACOs, 97 qualified for shared savings payments upwards of $422 million. So a little math seems to indicate the opposite: ACOs actually cost CMS $11 million in 2014.
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