Rise in Medicare ACO Participation in 2024: CMS News

The Centers for Medicare & Medicaid Services (CMS) recently announced an increased participation in its ACO initiatives this year, promising better and more coordinated care for patients with Medicare.

Here are the major highlights of the announcement:

• 19 new Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program) to receive over $20 million in advance investment payments (AIPs).
• 50 new ACOs have joined the program alongside 71 existing, renewed ACOs, totaling 480 ACOs now in the Shared Savings Program.
• Overall, about 13.7 million people with Traditional Medicare are now part of ACOs, which is a 3% increase since 2023.
• Three innovative ACO initiatives continue to grow: the Shared Savings Program, the ACO REACH Model, and the Kidney Care Choices model.

The CMS announced that this year, 19 newly formed accountable care organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program) are set to receive upwards of $20 million in advance investment payments (AIPs). This move is set to help these ACOs to provide better care for currently underserved populations. 50 new ACOs have also joined the program, adding to 71 existing ACOs. This brings the total to 480 ACOs currently in the Shared Services Program, making it the largest program of its kind in the US. Another 245 organizations continue participating in the ACO Realizing Equity, Access, and Community Health (ACO REACH) and Kidney Care Choices (KCC) models offered by the CMS Innovation Center.

About 13.7 million people with Traditional Medicare are aligned to an ACO this year marking a 3% increase since last year. The significance of these figures lies in the fact that ACOs have proved to show superior quality performance compared to non-ACO participants. ACOs have further shown to generate year-over-year savings for the Medicare Trust Fund.

In the 2023 Physician Fee Schedule final rule, actions were taken by CMS in the Shared Savings Program to ensure better alignment of value-based programs, strengthen accountable care, and establish a more impartial healthcare system, including scaling components from an Innovation Center model test that had shown positive results in healthcare quality and savings. Keeping in mind the success of the ACO Investment model in increasing participation in underserved areas and saving Medicare Trust Funds, CMS has integrated key elements into the Shared Savings Program as Advance Investment Payments (AIPs.) CMS has mentioned an already noticeable increase in participation among healthcare providers from remote areas, similar to the success observed in the initial model test.

The new AIPs have been initiated with the aim of facilitating rural and underserved area healthcare providers to establish the infrastructure required for them to function and succeed as ACOs.

The goal of increasing the number and presence of Accountable Care Organizations (ACOs) in underserved communities is to address racial and ethnic disparities found among individuals with Traditional Medicare in accountable care relationships.

• This year the Shared Savings Program covers 480 ACOs, including 634,657 health care providers and serving over 10.8 million individuals with Traditional Medicare. 
• Healthcare delivery to patients with Traditional Medicare will occur in 9,032 Federally Qualified Health Centers, Rural Health Clinics, and critical access hospitals, marking a 27% increase from 2023.
• The ACO REACH Model will consist of 122 ACOs, with 173,004 healthcare providers caring for an estimated 2.6 million people with Traditional Medicare. This signals an increase in participation of above 25% from the previous year.
• The KCC model for 2024 includes 123 Kidney Contracting Entities (KCEs) and CMS Kidney Care First (KCF) Practices, featuring feature over 9,227 participating healthcare providers and organizations, a 10% increase from the previous year, servicing 282,335 individuals with Medicare. 

You can read the detailed CMS report on their official website. 

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