Page 2 - ACO Report Revised

Declining Growth—But Doing Better at Shared Savings

CMS estimates in 2020 ACOs ACO Shared Savings
participating in the Shared Savings Aggregate and Average/ACO
Program “earned performance pay-
ments (shared savings) totaling near-
ly $2.3 billion while saving Medicare
approximately $1.9 billion, marking
the fourth consecutive year of net
savings for Medicare.” 5

Notably, the majority of ACOs
shared savings with CMS in 2020.

ACO Quality Drivers Source: CMS

The ACO overall average quali-
ty score is 97.8 according to CMS 2020
data. The score range is from 96.9 to
100.0. With a score less than 97.0,
44% of 513 ACOs show room for qual-
ity improvement. In contrast, 14% of
ACOs had a perfect 100.0 score and
5% earned a 99.0 to 99.9 score. There
is no correlation in quality scores be-
tween entities accepting one-sided Source: CMS. See the Guide to Quality Performance Scoring
versus two-sided financial risk.* Methods for Accountable Care Organizations (cms.gov).

Quality score improvement re-
quires focus on the CMS imperatives of cost reduction, care improvement and patient en-
gagement.

ACOs vying for commercial market business must additionally consider quality ex-
pectations that encompass the organization’s:
• Provider network depth—number of providers by specialty and type of ser-
vices.

• Provider network geographic coverage.
• Governance/decision making structure.

• Financial model for aligning provider, patient care and business objectives.

* Under the one-sided model (Track 1) an ACO may share in savings without liability for shared losses. ACOs choosing the two-sided
option (Track 2 and Track 3) may share in both savings and losses.

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