Medicare Shared Savings Program: public reporting and shared savings distributions

Area of Science:

• Health Policy
• Healthcare Management
• Health Economics

Background:

• The Medicare Shared Savings Program (MSSP) incentivizes Accountable Care Organizations (ACOs) to improve quality and reduce costs.
• Understanding how ACOs distribute shared savings is crucial for program effectiveness and participant engagement.

Purpose of the Study:

• To assess public reporting of shared savings distribution plans by MSSP ACOs.
• To analyze the composition of these distribution plans.
• To identify characteristics of ACOs associated with successful shared savings generation.

Main Methods:

• A cross-sectional study analyzing data from 338 active MSSP ACOs launched through January 2014.
• ACO websites were reviewed for descriptive characteristics and shared savings distribution plan details.
• MSSP results from 2012 and 2013 start date ACOs were used to investigate associations with savings generation.

Main Results:

• 93% of ACOs had websites, and 84% provided general information on savings distribution.
• Only 52% reported detailed allocation percentages, with an average of 63% to participants and 33% to infrastructure.
• ACOs including hospitals allocated more to participants (69% vs. 58%).
• Distributing over 50% to primary care providers and specialists, or having >10 participating entities, correlated with generating savings.

Conclusions:

• A majority of MSSP ACOs provide some information on shared savings distribution, but detailed reporting is less common.
• Shared savings distribution plans exhibit wide variation among ACOs.
• No single distribution plan guarantees ACO success; further research into savings predictors is needed.