Medicare fee-for-service accountable care organizations are thriving, according to the Centers for Medicare and Medicaid Services.
Provider participation in the Shared Savings Program, Kidney Care Choices and ACO Realizing Equity, Accountability and Community Health—known as ACO REACH—is higher this year, CMS announced Monday. Nearly half of fee-for-service Medicare beneficiaries, or 13.7 million people, are covered under ACOs this year, a 3% increase, the agency said in a news release.
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"One of CMS' top priorities is to expand access to quality, affordable health coverage and care," Administrator Chiquita Brooks-LaSure said in the news release. "Accountable care initiatives—which give more tools to healthcare providers to deliver better care and and help people receive more coordinated care—through programs like the Medicare Shared Savings Program and the [Center for Medicare and Medicaid Innovation] accountable care initiatives are critical to achieving this vision."
In 2021, the innovation center declared a goal to have all fee-for-service Medicare enrollees associated with accountable care arrangements by 2030.
Since then, CMS has taken steps to attract more providers and encourage more ACOs to form. For instance, the agency reworked the Shared Savings Program to promote risk sharing, offer upfront funding, and focus on rural and underserved enrollees. CMS also scrapped the Geographic Direct Contracting Model and replaced the Global and Professional Direct Contracting Model with ACO REACH.
The Shared Savings Program has 480 ACOs on board this year, including 71 renewals, 50 additional preexisting ACOs and 19 newly formed ACOs, CMS announced. These organizations comprise nearly 635,000 providers that treat more than 10.8 million beneficiaries, the agency said. Those providers include more than 9,000 community health centers, rural health clinics and critical access hospitals, which is 27% more than last year, according to CMS.
The ACO REACH model has signed up more than 173,000 participants—including more than 1,000 community health centers, rural health clinics and critical access hospitals—within 122 ACOs that manage care for about 2.6 million beneficiaries. Kidney Care Choices covers more than 282,000 people through 123 ACOs composed of more than 9,200 providers.
"[The National Association of ACOs] is happy to see growth in these important CMS programs, which was helped by changes put in place this year to help more provider organizations join value-based care models," President and CEO Clif Gaus said in a news release.
The trade group recommends CMS further modify these ACO models to accelerate progress toward the 2030 goal, such as revamping how benchmarks are set, relaxing reporting requirements and altering patient engagement rules.
