By Gregg A. Masters, MPH
Most of us watching and trying to interpret the ACO tea leaves are both challenged yet determined to assimilate a coherent picture of what’s happening at the ‘industry zeitgeist’ level. As noted previously, once you’ve seen one ACO, you seen one ACO.
Since there is ample confusion from the differences between ‘certification’ vs. ‘accreditation’ and the role of public vs. private oversight and engagement in ACO operations, that picture will only be built via a composite of discrete entity and industry reporting – both mandatory and voluntary.
Some of the ‘results’ reported to date at least in the commercial (vs. Medicare ‘MSSP’ sector) have been – well -‘alarmingly successful’ using traditional HMO use metrics of admits/1000, bed days/1000 and ED encounters/1000, see: ACOs, ‘HMO lite’ or ‘DNA of the Transformation’? These results albeit ‘preliminary’ are given contextual significance when one compares the reported experience with the modest savings projections assumed in the MSSP.
Yet official word came last month via Bloomberg in ‘First ACO Results Due This Summer, CMS Official Says’:
The first results of the Pioneer accountable care organization initiative will be available this summer, a Centers for Medicare & Medicaid Services official told Congress March 20.
Richard J. Gilfillan, director of CMS’s Center for Medicare and Medicaid Innovation, told the Senate Finance Committee that CMMI is working on numerous programs that could alter the way health care is delivered, but added results of many of CMMI’s projects may not be known for some time.
A CMS spokesperson told BNA the data to be released this summer will “provide a complete and accurate picture of the first performance year of the Pioneer ACO model.”
Gilfillan at the hearing sought to ease the concerns of senators who want to see quicker results from CMMI in its work to move Medicare from a fee-for-service program to one based on value-based purchasing