Medicare Compliance & Reimbursement

If you’re looking to increase your MACRA savvy and jump into an Advanced Alternative Payment Model (APM), consider a Medicare Shared Savings Program Accountable Care Organization, suggests a new HHS Office of Inspector General (OIG) study.

Tip: One of the pathways to the higher level (and higher paying) Medicare reimbursement models under MACRA’s Quality Payment Program is by participating in a Medicare Shared Savings Program (MSSP).

The OIG published a study in its most recent Work Plan that spotlighted the long-term savings of investing in MSSPs. “Over the first 3 years of the program, 428 participating Shared Savings Program ACOs served 9.7 million beneficiaries,” the OIG release said. “During that time, most of these ACOs reduced Medicare spending compared to their benchmarks, achieving a net spending reduction of nearly $1 billion.” In addition to the savings, the OIG remarked that the ACO’s also improved on their quality measures by about 82 percent, “outperformed fee-for service providers” on quality care by 81 percent, and some even “reduced spending by an average of $673 per beneficiary.”

For a closer look at the OIG report in its entirety, visit oig.hhs.gov/oei/reports/oei-02-15-00450.pdf.