Performance of New York's Accountable Care Organizations in Year 2 of the Medicare Shared Savings Program

Authors: Gregory C. Burke, Suzanne C. Brundage 

See the related press release.

The Medicare Shared Savings Program, a nationwide accountable care program sponsored by the Centers for Medicare and Medicaid Innovation, is changing the New York's health care landscape. It is encouraging organized provider groups across the nation to develop high-performing, integrated health care delivery systems, and it dovetails with other State plans to move from fee-for-service to value-based payment systems, such as DSRIP.

Twenty-one accountable care organizations (ACOs) in New York State have been in the program long enough to have generated results, which have been analyzed and reported by CMS. In Year 1, their cost savings and quality measures were roughly in line with other program participants nationwide. In Year 2, they were comparatively strong on quality measures but less impressive in terms of cost savings: in aggregate, those 21 ACOs generated savings to Medicare of $1.6 million, a savings rate of 0.05 percent of total expenditures.

This new report from UHF reviews results from New York's ACOs participating in the program, and seeks to identify characteristics associated with success program. Among the factors analyzed were experience, size, organizational model, and geography. Some basic design elements of the MSSP program (notably attribution and benchmarking) appear to affect ACOs' ability to generate savings, and we analyze the mechanics of those elements too.