Medicare accountable care medical
groups cover almost two-thirds of U.S.
Now 424 ACOs dedicated to better care
for seniors, others in Medicare fee for service
April 22, 2015 – Almost 70 percent
of the U.S. population now lives in communities served by accountable
care organizations (ACOs), which were created by Obamacare to provided
Medicare patients with better coordinated and higher quality health
care. A new analysis also shows that 44 percent live in areas served by
two or more ACOs.
figures come from
new research by the consulting firm Oliver Wyman, based on the
Department of Health and Human Services’ announcement of the latest
class of ACOs approved to participate in Medicare’s ACO programs.
The latest round of approvals in
January brings the total of Medicare ACOs to 426, up from 368 in January
2014 and 134 in 2013. Oliver Wyman has identified an additional 159 ACOs,
bringing the estimated total to 585, an increase of 12 percent from the
“One of the key reforms in the
Affordable Care Act is creating Accountable Care Organizations (ACOs).
ACOs, are groups of doctors, hospitals, and other health care providers
that have agreed to work together to give their Medicare patients better
coordinated, high quality care,” according to the
CMS blog at the time of the last announcement in January.
“To the extent that they succeed in
providing more effective and efficient care, they can share in the
savings to the Medicare program. Interim financial results for 114 ACOs
that began work in 2012 show that they generated $128 million in savings
for the Medicare trust fund in the first year —while maintaining high
quality patient care.
“Additionally, initial results from
an independent evaluation of 23 Pioneer ACOs, which are those that have
more experience with coordinated care, show that they saved the Medicare
program $147 million in their first year of operation.”
Despite well-publicized departures
from Medicare’s Pioneer ACO Program, the concept appears to now have
taken hold and is becoming a driving force in better care for Medicare
● About 5.6 million Medicare
beneficiaries, or about 11 percent of total Medicare beneficiaries, now
receive their healthcare from ACOs participating in Medicare’s ACO
● These organizations also
provide care to 35 million non-Medicare patients, about 6 percent more
than last year.
● ACOs collectively serve
between 49 and 59 million U.S. residents, or between 15 and 17 percent
of the population.
“ The slowdown we’re seeing in the
growth of ACOs was almost inevitable, given the pace of change of the
past two years,” says Niyum Gandhi, a partner in Oliver Wyman’s Health &
Life Sciences practice and one of the firm’s experts on ACOs.
“The next big spurt will be more in
effectiveness and sophistication than it will be in growth in numbers of
ACOs." Gandhi also cites that the changes to the rules that CMS proposed
this past winter, especially the Next Generation ACO model, could give
ACOs the boost they need to compete more aggressively.
● About Oliver Wyman - Oliver
Wyman reports to be a global leader in management consulting. The firm's
3,700 professionals “help clients optimize their business, improve their
operations and risk profile, and accelerate their organizational
performance to seize the most attractive opportunities”. Oliver Wyman is
a wholly owned subsidiary of Marsh & McLennan Companies [NYSE:MMC]. For
more information, visit
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Rule reflects focus on primary care and improved incentives for
participation, quality, and efficiency - Dec. 2, 2014
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