Study: MSSP results proving ACOs are ‘an ideal model’ for delivery

Accountable care organizations participating in the Medicare Shared Savings Program have generated $1 billion in savings since their inception—leading the way in value-based care, according to a new report from data activation platform company, Innovaccer.

For its report, titled, “State of the Union Report for Medicare ACOs,” Innovaccer used its proprietary algorithm to look at the quality, performance, utilization and expenditure data for every region in the U.S., based on the performance of Medicare ACOs participating in the MSSP in program year 2017.

Executives at Innovaccer say the report will help all Medicare ACOs—especially the ones participating in MSSP—to assess their expenditure and resource utilization against the national and regional averages.

The savings accrued by the MSSP ACOs has established ACOs as an ideal model for the future of healthcare, San Francisco-based Innovaccer says. “The adoption of value-based care models is expected to account for 59 percent of healthcare payments by 2020, as the healthcare industry uses value-based care to address these high-cost utilizers,” according to San Francisco-based Innovaccer’s report.

“The only term with which value-based care resonates completely is the accountable care organization,” says Abhinav Shashank, Innovaccer’s CEO. “They are the torchbearers of the greatest revolution in the space, and with this report, we aim to accelerate their journey towards a better tomorrow- a tomorrow with quality care, reduced costs, and enhanced patient/physician experience, and reduced costs reside at the center.”

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A physical therapist, right, assists a patient at Jukoukai Hospital in Tokyo, Japan, on Thursday, Sept. 11, 2014. Japan spent more than any other country in the world keeping people 65 years or older in hospital in 2011, according to Organization for Economic Cooperation and Development data, while medical expenses are forecast to rise 54 percent to 54 trillion yen ($506 billion) in fiscal 2025 compared with 2012, according to the Ministry of Health, Labor and Welfare. Photographer: Akio Kon/Bloomberg

Innovaccer identified the top measures that contribute the most to expenditure per capita. The report shows that out of 53 various parameters affecting the performance of Medicare ACOs, nine were found to be the most significant. These included: long-term care hospital discharges; COPD or asthma discharges; skilled nursing facility discharges; emergency department visits; MRI events; unplanned admissions for patients with chronic conditions; use of imaging for low back pain; use of statin therapy; and controlling high blood pressure.

The study also showed that the national average of the risk-adjusted expenditure per capita is more than $11,000, while the total national expenditure was more than $500,000. Some 22 states had their overall risk-adjusted expenditure per capita fall below the national average.

The report integrates Medicare ACO performance data with SDOH data, showing the vulnerability of all the states across the U.S. against the social factors affecting their populations. It found that North Dakota was the least vulnerable to SDOH factors, while Hawaii was the most vulnerable.

“ACOs are the present and the future of U.S. healthcare,” says David Nace MD, chief medical officer at Innovaccer. “They are the big brains, and they sit in the driver’s seat of value-based care, which is becoming the new face of the entire healthcare space. It is highly important to keep track of their performance at all times, stay updated, and always be on top of changes in the space.”

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