Limited Medicare ACO Quality Data Show Sharp Variations in Performance

Since the Obama administration launched its accountable care initiative as part of healthcare reform in 2012, the CMS has announced which hospital and physician networks in one of the programs have met cost targets and received shared savings. But so far, it has published little data on quality of care delivered by these networks, which were designed to deliver better care as well as lower costs for Medicare patients.

The $380 million in Medicare savings produced by accountable care organizations in the Shared Savings and Pioneer programs in 2012 have been well-publicized. But the CMS has not yet delivered on its stated goal of transparency for quality-of-care measures, which will be used to evaluate Medicare ACOs to determine whether they will receive financial bonuses or penalties. Quality measures ensure that ACOs—which are eligible to keep half to 70% of what they save—do not inappropriately skimp on care to win the savings bonuses.

“If you're going to collect 33 (quality) measures, I don't know why it is that the public doesn't have access to that information,” said Dr. Robert Berenson, an expert on Medicare policy and senior fellow at the Urban Institute. Public access to the data adds “credibility and accountability” to the ACO program and could help Medicare beneficiaries decide whether to join an ACO if proposals to establish enrollment in the program are enacted, Berenson said. Lack of confidence in the validity of the quality data may be one reason for delays, he said.

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Source: Modern Healthcare