Medicare Accountable Care Organizations are in full swing and healthcare systems are starting to fully grasp what it takes to manage them.
A recently published article in JAMA Internal Medicine explored the largest and most pressing problem with Medicare ACOs: managing the member population. The authors explored the stability of the member populations, network leakage, and proportion of care provided to ACO beneficiaries relative to other patients.
The results from the JAMA research were unsurprising. Medicare ACO populations are extremely unstable, with one in three patients moving in or out of the ACO year-to-year. Leakage to other networks is also extraordinarily high, with 67% of specialty visits occurring outside of the ACO network. Lastly, the amount of care devoted to ACO beneficiaries is only about 38% of the total care provided at a system. These are not the results anyone wants to see – neither Medicare nor providers.