Despite long-term care leaders’ concerns about not getting a fair share of the pie, ACOs continue to be the apple of the administration’s eye. Figures released Monday show ACO saved federal coffers $739.4 million in 2018. 

Centers for Medicare & Medicaid Services Administrator Seema Verma said the latest performance results revealed ACOs that received shared savings payments saw decreases in inpatient, emergency room and post-acute spending and utilization. ACOs that increased spending relative to their targets, however, tended to show increases in those areas. 

“ACOs taking on downside risk showed an average reduction in spending relative to their targets of $96 per beneficiary, compared to $68 for ACOs that did not take on downside risk,” Verma wrote in a Health Affairs blog post. “This trend is one of the reasons that the greater accountability for ACOs included in Pathways to Success, along with greater flexibility for them to innovate, will lead to better, more efficient care for Medicare beneficiaries.”

She also touted Pathways to Success and said it will “put ACOs on a quicker path to taking on real risk, with downside risk generally required after two years for new ACOs, while offering ACOs more flexibilities to coordinate care and innovate.” 

“We are excited to see growing interest, and we will continue to support healthcare providers on the front lines who are hard at work building new ways to deliver higher quality care at lower cost,” Verma said.

Skilled nursing operators and many other post-acute providers, meanwhile, have said they are often being treated as an afterthought by ACO administrators. Many skilled nursing operators said they have been squeezed by the ACO approach, while researchers have also reported that those who reduced spending might not have performed well enough to get a bonus that would have made their initial investment worthwhile.