Do MSSP ACOs Result in Improved Outcomes and Lower Costs?

In the effort to transition to value-based care, ACOs are leading the way. There are over 900 ACO contracts covering 32 million lives in the United States. One major part of that, Medicare Shared Savings Programs (MSSPs) are often cited as an example of a large-scale initiative that saves costs and improves outcomes. But do they?

A new study from researchers at the University of Michigan School of Public Health, and published in the Annals of Internal Medicine, suggests that while most other studies show that MSSP ACOs do result in at least some improved outcomes and lowered costs, accounting for nonrandom clinician exits suggests no real significant outcomes.

Related: Lessons Learned From MSSP ACOs: What Execs Should Know

The reason for the lack of improvement, according to the study, is because higher-cost clinicians and beneficiaries are more likely to exit MSSP ACOs, potentially distorting data on costs and outcomes in other studies.

“Our results suggest that improved quality and spending performance in this voluntary program may have been driven by nonrandom exit of clinicians and their patient panels from the MSSP,” said the authors.

The authors concluded that pruning those high-cost physicians could have significant impact on purported savings and even explain the phenomenon that some have found that MSSP savings increase over time.