Table 2.
Description of MSSP ACO Characteristics and 2013 Performance Year Results Categorized by Donabedian’s Model
| All MSSP ACOs | Generated savings | |||
|---|---|---|---|---|
| Yes (%) | No (%) | p-value | ||
| Structure | ||||
| Number of MSSP ACOs | ||||
| All | 220 | 58 (26) | 162 (74) | |
| By start date | 0.180 | |||
| 4/1/2012 | 27 | 8 (30) | 19 (70) | |
| 7/1/2012 | 87 | 28 (32) | 59 (68) | |
| 1/1/2013 | 106 | 22 (21) | 84 (79) | |
| By track | 0.480 | |||
| Track 1 | 215 | 56 (26) | 159 (74) | |
| Track 2 | 5 | 2 (40) | 3 (60) | |
| Number of total assigned beneficiaries | 0.151 | |||
| Average | 16,706 | 16,129 | 16,912 | |
| 3,900–10,000 | 82 | 25 (30) | 57 (70) | |
| 10,001–20,000 | 88 | 17 (19) | 71 (81) | |
| 20,001–140,000 | 50 | 16 (32) | 34 (68) | |
|
| ||||
| Process | ||||
| Minimum Savings Rate (MSR) | 0.540 | |||
| Average % | 2.89 | 2.93 | 2.88 | |
| MSR ≤2.9% | 110 | 27 (25) | 83 (75) | |
| MSR >2.9% | 110 | 31 (28) | 79 (72) | |
| Per Capita Benchmarks Expenditures (Target) | 0.007 | |||
| Average $ | $11,786 | $13,386 | $11,214 | |
| $5,000-$9,000 | 40 | 5 (13) | 35 (88) | |
| $9,001-$11,000 | 57 | 11 (19) | 4652 (81) | |
| $11,001-$13,000 | 59 | 16 (27) | 43 (73) | |
| $13,001-$23,000 | 64 | 26 (41) | 38 (59) | |
|
| ||||
| Outcome | ||||
| Per Capita Expenditures (Actual) | 0.149 | |||
| Average | $11,712 | $12,500 | $11,429 | |
| $4,000- $9,000 | 41 | 8 (20) | 33 (80) | |
| $9,001-$11,000 | 54 | 11 (20) | 43 (80) | |
| $11,001-$13,000 | 62 | 16 (26) | 46 (74) | |
| $13,001-$24,000 | 63 | 23 (37) | 40 (63) | |
| Shared Savings Result | 0.000 | |||
| Lost $ | 1 | 0 | 1 (100) | |
| Neutral | 167 | 6 (4) | 161 (96) | |
| Earned $ | 52 | 52 (100) | 0 | |
| Quality Reporting | 0.045 | |||
| Did not successfully report quality in 2013 | 6 | 4 (66) | 2 (34) | |
| Did not successfully report quality in 2012, but did in 2013 | 5 | 2 (40) | 3 (60) | |
| Successfully reported quality in each required year | 209 | 52 (25) | 157 (75) | |
| Quality Score | 0.750 | |||
| Average % | 72 | 72 | 72 | |
| 26%−66% | 56 | 12 (22) | 44 (78) | |
| 67%−74% | 56 | 17 (30) | 39 (70) | |
| 75%−79% | 50 | 13 (26) | 37 (74) | |
| 80%−91% | 58 | 16 (28) | 42 (72) | |
Table 2 Source: Analysis based on Medicare Shared Savings Program Accountable Care Organizations Performance Year 1 Results (Centers for Medicare and Medicaid Services, 2014c).
Notes: Values represent numbers/percentages unless otherwise indicated in the row. Percentages shown are calculated across for each characteristic. For each row, the denominator is the number of MSSP organizations that met the given characteristic and the numerators are the numbers of organizations meeting the characteristic that did or did not generate savings. Categories for total assigned beneficiaries, minimum savings rate, per capita benchmark and per capita expenditures were created to demonstrate distributions in addition to averages. Target per capita benchmark expenditures data resulted in a p-value of 0.007 when tested categorically using an x2 test, however when tested continuously the resulting p-value was <0.0001. The Quality Score categories represent quartiles. In order to generate savings, an ACO’s Generated Savings Rate was greater than its Minimum Savings Rate.