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OIG Report Finds ACOs Outperform FFS Providers on Quality Performance 

In August of 2017 the Department of Health and Human Services (DHHS) Office of Inspector General (OIG) issued a report entitled, “Medicare Program Shared Savings ACOs Have Shown Potential for Reducing Spending and Improving Quality.” In the report, the OIG details key findings related to how ACOs are outperforming their fee-for-service (FFS) peers. 

Report Highlights: Quality 

  • The report found that ACOs outperformed FFS providers on most quality measures and improved quality over time in the program1
    • On average, ACOs outperformed FFS providers on 81 percent (22 of 27) of the individual quality measures studied
    • ACOs performed better than 90 percent of all FFS providers when looking at hospital readmissions
    • ACOs outperformed at least 80 percent of FFS providers on the following measures:
      • Hospital Readmissions
      • Screening for Future Fall Risk
      • Primary Care Physicians Qualifying for EHR Incentive Payment
      • Depression Screenings and Follow-Up Plan
  • The report also found that ACOs’ quality performance continues to outpace FFS providers’ quality performance over time
    • ACOs performed better than fee-for-service providers for 73 percent of measures in 2013, 77 percent of measures in 2014, and 86 percent of measures in 2015 

These findings reiterate that ACOs are providing high quality care to the Medicare beneficiaries they serve and continue to improve quality over time. It is critical that the Centers for Medicare & Medicaid Services (CMS) continue to support ACOs in their efforts to serve Medicare beneficiaries by decreasing regulatory burdens associated with quality reporting to allow these organizations to continue to focus on and improve the quality of care provided to patients, which aligns with the Administration’s “Patients Over Paperwork” initiative. 

1 CMS based this analysis on 27 measures that had at least 2 years of data that also had comparable data for FFS providers. CMS analyzed the data for the most recent year available for each measure, and considered ACOs to outperform FFS providers if the median score for all ACOs exceeded the 50th percentile—the median score—for all FFS providers.