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ACO Models & 2024 Participation
The Centers for Medicare and Medicaid Services (CMS) just released the latest numbers on participation in accountable care organizations (ACOs) for 2024. There are three basic models for ACOs. They include the Medicare Shared Savings Program (MSSP), the ACO Realizing Equity, Access, and Community Health (REACH), and the Kidney Care Choices (KCC) models. ACO REACH and KCC are both still pilot models under CMS’s innovation arm, CMMI. Combined, these 3 models serve 13.7 million Medicare beneficiaries, which is almost half of all traditional Medicare enrollees. This is a 3% increase from 2023.
ACO Cost Savings
There are 480 MSSP ACOs in 2024 with 634,657 participating providers and organizations serving over 10.8 million beneficiaries. CMS introduced advance investment payments (AIPs) to MSSPs in 2024 which provide additional permanent payment options for providers caring for underserved populations. CMS will provide over $20 million in AIPs in 2024. In addition, there are 122 ACO REACHs with 173,004 participating providers and organizations serving over 2.6 million beneficiaries. In 2024, 1,042 FQHCs, Rural Health Clinics, and Critical Access Hospitals are participating in ACO REACH, which is a 25% increase from 2023. Lastly, there are 123 KCCs with 9,227 participating providers and organizations, a 10% increase from 2023, serving 282,335 beneficiaries with chronic and end-stage kidney disease. While CMS continues to learn from and tweak these models, they continue to show year-over-year savings for Medicare. These savings are being shared with the providers and organizations that have done the work to create the improvements, as it should be. At the same time, performance within ACOs on patient outcome and quality measures are consistently higher than for those not participating in ACOs. In addition, CMS continues to focus on increasing access and addressing equity issues on multiple fronts. While definitely not perfect, ACOs seem to be showing the way towards meaningful healthcare reform.
Source Material:
“Participation Continues to Grow in CMS’ Accountable Care Organization Initiatives in 2024” by CMS, released on January 29, 2024, and available at https://www.cms.gov/newsroom/press-releases/participation-continues-grow-cms-accountable-care-organization-initiatives-2024
