OIG: Medicare ACO successes should inform CMS efforts to transform care

Medicare accountable care organizations report a number of successful strategies to reduce Medicare spending and improve quality of care for patients, which should inform the Centers for Medicare & Medicaid Services’ efforts to transform the health care system from fee-for-service to value-based care, the Department of Health and Human Services’ Office of Inspector General said in a report this week. The finding is based on interviews with 20 Medicare Shared Savings Program ACOs that reduced spending relative to their benchmark and had an overall quality score of 90 or more in their second, third or fourth performance year. The report recommends that CMS review the impact of recent changes to the program on ACOs' ability to promote value-based care; and expand efforts to share strategies that reduce spending and improve quality, integrate physical and behavioral health services, address social determinants of health, and encourage patients to share behavioral health data. It also recommends the agency adopt outcome-based measures and better align measures across programs; and assess and share information about ACOs' use of the skilled nursing facility three-day rule waiver and apply the results to its programs. In comments in the report, CMS agreed with the recommendations.