Farzad Mostashari, MD, of Aledade, and Richard Gilfillan, MD, of Trinity Health, highlight the successes of accountable care organizations (ACOs) and how they've impacted care across the healthcare system, and offered suggestions for improving the Medicare Shared Savings Program.
The accountable care organization (ACO) movement may be slow, but it is having an effect that is rippling throughout the healthcare system, said Farzad Mostashari, MD, CEO and cofounder of Aledade, during a session at the spring 2018 conference of the National Association of ACOs.
Mostashari added that he is proud of the ACO movement, which has come into question with results, such as those from Avalere, finding that the Medicare Shared Savings Program (MSSP) ACOs have fallen short of projected savings estimates. He disagrees with people who say the results have so far been underwhelming with the explanation that benchmarks haven’t been a good representation of the benefit being derived from the program.
“I think that the quality improvements and the quality gains have been underappreciated. I think that the multiplier effect, the spillover effects on Medicare and other populations, has been underappreciated,” he said. “I think it gets better over time. Let’s not throw out the baby with the bathwater here.”
Mostashari provided 4 policy predictions for where ACOs are going (from most likely to happen to least likely):
Richard Gilfillan, MD, CEO of Trinity Health, explained that his organization views expansion of ACOs as a way to be a patient-centered health system that looks at populations and at individuals, rather than just services being paid for.
Trinity has seen significant improvements on hospital safety and readmissions, he said, even though the cost savings haven’t been exactly where they would want them. However, he echoed what Mostashari said about the spillover effects of the program.
“Medicare annual spend is $200 billion less a year compared to the projections that were done in 2010 for the period of time from 2020 to 2030,” Gilfillan said. “I believe we have seen vast effects across the system.”
Gilfillan finished up by providing Trinity’s position on how to optimize ACO results, which included:
“I urge people to not jump to conclusions of [ACOs] not working,” said Gilfillan. “It’s a longer journey than we thought, but it is moving along.”