In Performance Year 2024, the 115 accountable care organizations (ACOs) that participated in ACO REACH generated $2.5 billion in gross savings, with $988.3 million returned directly to the Centers for Medicare and Medicaid Services (CMS), for the care of 2.5 million seniors, according to a new report.
ACO REACH is an advanced ACO initiative to promote patient-centered care, lower costs, and align payment systems for Original Medicare beneficiaries through ACO risk-sharing and prospective payment.
Financial and quality results show the ACOs achieved a 6.7% net savings rate.
Gross savings per beneficiary per month increased 24% between 2023 and 2024.
CMS noted that the financial and quality results are calculated differently than in the model’s formal evaluation.
Results are presented in comparison to prospective financial benchmarks set for model participants.
This approach aims to create transparent and understandable incentives for participating REACH ACOs to improve quality of care and reduce spending.
In contrast, the evaluation considers the model’s spending and quality impact relative to a comparison group to evaluate performance compared to what would have occurred absent the model.
CMS reported that the vast majority of participants maintained the delivery of high-quality care in PY 2024.
They achieved an average total quality score of 80.4% across the 101 Standard and New Entrant ACOs, and 86.2% across the 14 High Needs Population ACOs.
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Mara McDermott, chief executive officer of Accountable for Health, spoke to the more conservative financial performance estimates in the formal evaluations.
“The current evaluation methodology was developed when accountable care represented a relatively small share of traditional Medicare,” McDermott said.
“Today, more than half of traditional Medicare beneficiaries receive care from providers participating in accountable care arrangements.
Identifying an appropriate comparison group has become increasingly difficult, causing the evaluations to understate the impact of accountable care.
Additionally, the evaluation reflects performance from 2023, and the model has evolved through multiple changes since then.
Policymakers should place greater weight on the most current evidence available as they consider the future of accountable care.
NAACOS said the Performance Year 2024 results demonstrate the success and impact of the model’s innovative design and focus on high-needs populations.
NAACOS looks forward to seeing these features scale through the upcoming LEAD model.
As the healthcare system continues to evolve, the success of ACO REACH in reducing costs and improving quality of care will be closely watched.
The $2.5 billion in gross savings generated by ACO REACH is a significant achievement and shows the potential of value-based care to drive positive change in the healthcare system.
