Healthcare data company Innovaccer Inc. has released a multi-layered report on the state of U.S. accountable care organizations (ACOs), highlighting their journeys and how they have been able to generate more than $1 billion in savings to date.
Researchers from the Silicon Valley-based healthcare company noted that the adoption of value-based care models is expected to account for 59 percent of healthcare payments by 2020, as the industry uses value-based care to address these high-cost utilizers. As a matter of fact, they wrote, going forward, “no outcome, no income” is the watchword for U.S. healthcare.
So, they set out to conduct a comprehensive analysis of ACOs across the U.S., coming up with findings that they believe are going to be useful in shaping the future of value-based care. The report, “State of the Union Report for Medicare ACOs,” also gives insight into the key drivers in the value-based payment space, national and state-level analysis to explain the dominating factors in each region, and individual performance analysis of each ACO.
Researchers attest that the report will enable all Medicare ACOs, especially the ones participating in the Medicare Shared Savings Program (MSSP), to assess their expenditure and resource utilization against the national and regional average, and identify the scope of improvement. The report is divided into three parts:
● Part 1 discusses the value-based journey of Medicare Accountable Care Organizations in the USA and their current state.
● Part 2 provides the national and regional level performance analysis of Medicare ACOs across the nation spread across various regions.
● Part 3 highlights the value-based journey of every Medicare ACO, especially the ones participating in the Medicare Shared Savings Program (MSSP) along with their detailed performance analysis.
According to the researchers, “Since their inception, the MSSP ACOs saved around $1 billion for the U.S. healthcare. This has not just led to the biggest accountability shift witnessed in the healthcare space, but has also established ACOs as the ideal models on the foundations of which the future is being planned. They have been managing over 10.5 million lives.”
Some key highlights from the report include:
● As of May 2019, over 60 million beneficiaries were enrolled in Medicare. Out of them, approximately 62 percent were enrolled in the Original Medicare, while the rest had Medicare Advantage or some other form of private plans.
● Out of 53 various parameters affecting the performance of ACOs, 9 were found to be the most affecting parameters.
● The national average of the risk-adjusted expenditure per capita is over $11,000, while the total national expenditure was over $500,000.
● 22 states had their overall risk-adjusted expenditure per capita fall below the national average.
● Based on the analysis of the social determinants of health affecting the U.S., it was 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 US healthcare. 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,” said David Nace M.D., chief medical officer at Innovaccer. “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. This report is exactly the thing they need.”
For a more detailed analysis on the findings, readers can access the report here.
