U.S. Department of Health and Human Services Office of Inspector General: ACOs’ Strategies for Transitioning to Value-Based Care – Lessons From the Medicare Shared Savings Program

by Gregg A. Masters, MPH

Many have suggested ACOs would not make a dent in restraining the growth of the U.S. healthcare spend, nor have a meaningful impact on elevating the quality of care provided to covered members or beneficiaries (patients).

From ‘HMO-lite‘ criticism to a range of ‘tepid’ to no patient channeling mechanisms, recent efforts to structure ACOs closer to more traditional gatekeeper model HMOs notwithstanding, ACOs are not likely to disappear anytime soon. In fact, the A/C/O – as an operating entity – is codified in U.S. healthcare lexicon just as are PPOs, HMOs, IPAs, etc. In other words, I doubt we’ll ever return to an unbridled fee-for-services model or adopt an ‘un-accountable care’ world view. The ‘genie’ is out of the bottle!

While the jury is still out and the ACO program from MSSP to Advanced Alernative Payment Models (AAPMs) continue to evolve, The Office of the Inspector General released in July 2019 ‘ACOs’ Strategies for Transitioning to Value-Based Care: Lessons From the Medicare Shared Savings Program’.

To access the full report, click here.





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