Early Performance of ACOs in Medicare

In the Medicare Shared Savings Program (MSSP) — the largest of the Medicare accountable care organization (ACO) programs — participating provider organizations share in savings with Medicare if they keep spending for an attributed population of fee-for-service beneficiaries sufficiently below a financial benchmark. Greater shared-savings bonuses are awarded to ACOs with higher performance on a set of quality measures. Unlike ACOs in the Medicare Pioneer program, very few ACOs in the MSSP face penalties for spending in excess of benchmarks because such downside risk is not currently required.