The Medicare Shared Savings Program was launched in 2012 and since then participating organizations report early gains, according to a report from Harvard Medical School.
Here are eight key notes on the program's outcomes:
1. In 2013, the early adopters lowered spending by 1.4 percent, representing a $238 million spending reduction. The early adopters were compared with a control group of non-accountable care organization participants.
2. The ACOs joining in 2013 didn't achieve savings in their first full year, showing the early success may not be replicated just by joining MSSP.
3. Medicare paid out $244 million in shared savings bonuses to the first two cohorts. But the 2012 lower spending didn't constitute net savings for Medicare.
4. The results showed ACOs without downside risk can achieve savings while incentives for lower spending are currently weak. J. Michael McWilliams, author of a study abut the program published in the New England Journal of Medicine, reports strengthening the incentives could accelerate savings.
5. The current benchmarking method for the ACOs doesn't incentivize savings because if the ACO lowers spending now, it will be penalized later with low benchmarks. If the program separated the benchmarks from previous savings, it would reward the ACO for cutting waste and provide necessary returns for future investment, according to the report.
6. Independent primary care groups in MSSP achieved greater savings than the hospital-integrated group. The independent groups have stronger incentives to prevent hospitalization under shared-savings.
7. ACOs with high spending in the region achieved greater savings than those with below regional average spending in the MSSP. When ACOs have more opportunities to cut, they make progress.
8. CMS recently proposed a new system where the ACO's benchmark is based on the average spending in the region, but the study authors also cautioned against this move because it could prompt ACOs with high spending to leave the program and diminish savings.
"These early results are encouraging overall," said Mr. McWilliams. "But building on the initial success of ACO models in Medicare will require stronger incentives and rigorous evaluations to identify groups of systematically successful ACOs whose organizational models and strategies can be disseminated."