ACOs earned nearly $2.3 billion in Medicare shared savings last year

More than two-thirds of accountable care organizations in the Medicare Shared Savings Program earned shared savings in 2020, CMS announced Wednesday.

ACOs in models with downside risk were significantly more likely to earn performance payments than those without it. Just 55% of ACOs in one-sided risk models received shared savings compared to 88% in two-sided risk models.

Medicare Shared Savings Program ACOs earned almost $2.3 billion in bonuses and saved taxpayers almost $1.9 billion.

“The 2020 Shared Savings Program results continue to demonstrate the impact ACOs have in improving quality and lowering health care costs,” CMS Administrator Chiquita Brooks-LaSure said in a news release. “CMS is similarly committed to moving healthcare providers to value-based payment and looks forward to partnering with the ACO community in a continued effort to advance these goals and promote affordability and sustainability.”

President Joe Biden’s administration recently laid out its vision for the future of value-based care in a Health Affairs blog post, saying it would emphasize coordinated, team-based care and hold providers more accountable for patient outcomes. That likely means an even greater reliance on total cost-of-care models like ACOs and pushing providers to take on more financial risk.

“While voluntary models can demonstrate a proof of concept, they limit the potential savings and full ability to test an intervention because participants opt-in when they believe they will benefit financially and opt-out (or never join) when they believe they are at risk for losses,” the blog post says.