Medicare gives first glimpse of ACO quality performance

The CMS for the first time publicly released individual performance data for Medicare accountable care organizations on 33 measures of healthcare quality.

The results for 220 of the participants (PDF) in the Medicare Shared Savings Program reveal how ACOs performed on measures (PDF) of patient experience, preventive care and disease management for some of the leading causes of death among U.S. elderly, including heart disease, cancer and diabetes.

Quality measures have been a point of contention for Medicare’s accountable care effort since it first began. Hospitals and doctors rejected an early proposal for 65 measures, which the CMS shaved to 33. Federal officials earlier this summer proposed an increase to 37 measures with some existing measures to be swapped for others.

The program’s financial incentives reward hospitals and medical groups that can slow the growth in medical expenses, but only if providers also meet targets for quality. For patients and policymakers, the quality measures serve as a check against the temptation for hospitals and doctors to withhold medical care in order to meet cost benchmarks tied to financial bonuses.

The CMS last week reported aggregate quality performance for more than 200 participating ACOs through last December.

Collectively, they scored better than other providers on 17 of the 22 quality measures for which there is comparable data. Public reporting on the performance of individual ACOs has so far been limited to five quality measures reported at medicare.gov. The CMS also released results of each ACOs’ financial performance last week: 53 of them reduced the cost of patient care enough to share $300 million in bonuses.

ACOs that joined the program in 2012 and 2013 were required to report quality scores through last December but were not yet required to meet performance targets, a condition that took effect in January.

Medicare launched the Shared Savings Program in April 2012 under a provision of the Patient Protection and Affordable Care Act. It has grown from 27 in the first cohort to about 340, with more expected to join in January.

The quality results released on Monday did not reflect the performances of the smaller number of organizations participating in the CMS Innovation Center’s more ambitious Pioneer ACO model.

Follow Melanie Evans on Twitter: @MHmevans