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Primary care-centric ACOs generate better savings and better outcomes

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Key Takeaways

  • Primary care-centric ACOs outperform peers in MSSP, achieving better outcomes and 2.4 times higher savings.
  • ACOs with over 50% primary care physicians consistently lower costs and earn savings through MSSP.
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PCC’s 2024 Evidence Report found primary care-centric ACOs generate more than two times higher savings through data integration.

© MargJohnsonVA - stock.adobe.com

© MargJohnsonVA - stock.adobe.com

According to the Primary Care Collaborative’s (PCC’s) 2024 Evidence Report, “Primary Care: The MVP of MSSP,” primary care-centric accountable care organizations (ACOs) provide better quality health outcomes and generate 2.4 times higher savings, compared to their peers. The 2024 Evidence Report, written in collaboration with Robert Graham Center and Simple Healthcare, considered more than six years of Medicare Shared Savings Program (MSSP) data, between 2017 and 2022.

“This report reinforces research demonstrating that access to primary care in total cost of care models curbs costs and boosts quality of care.” Ann Greiner, president and CEO of PCC and one of the authors of the report, said in a PCC release. “If Congress is serious about improving Medicare, it’s critical they include strengthening primary care at the heart of those efforts.”

ACOs comprised of more than 50% of primary care physicians consistently outperformed those with less than a majority of primary care physicians, according to the report. Primary care-centric ACOs were more likely to lower costs and earn back savings through MSSP.

“This research shows the central role that primary care has played in generating record savings in MSSP,” explained Mark Del Monte, CEO and EVP of the American Academy of Pediatrics and chair of PCC’s Board of Directors. “If policymakers want to continue building on the successes of the MSSP program, stronger investments in primary care through value-based models would be an important place to start.”

The report specifically draws attention to how organizations achieve better outcomes by leveraging unified patient health data. One of the three featured case studies looks at the Community Health Provider Alliance (CHPA), which notably reached a 10% savings rate by integrating data from more than 15 sources. According to the report, the approach enabled disease-specific learning labs and quality improvement initiatives, which contributed to the optimization of clinical strategies across all 20 CHPA community health centers.

“The PCC Evidence Report provides compelling evidence that value-based care programs are delivering meaningful results across health equity, quality and cost metrics,” Abhinav Shashank, cofounder and CEO of Innovaccer, Inc., the report’s champion supporter, said in an Innovaccer release. “The organizations highlighted in the report showcase how the right set of data integration and advanced analytics capabilities can drive significant improvements in risk-based contracts, ultimately benefiting patient populations. As we work toward [the Centers for Medicare and Medicaid Services] (CMS’s) 2030 goals for accountable care, primary care-focused ACOs and organizations are leading the way in demonstrating how data-driven strategy can transform health care delivery.”

CHPA, alongside the other two case studies, MSSP Enhanced ACO and One Health Nebraska, provided timely and actionable data to practices and community health centers (CHCs), which assisted with clinical decision-making. The ACOs were also able to establish learning communities/labs in which they shared best practices, improving inter-practice alignment and alignment with CHC, yet practices and CHCs were still able to achieve beneficial outcomes when working independently. Additionally, practices and CHCs were supported in their development of innovative strategies for care, and focus was placed on simple and proactive health care interventions with clearly defined outcomes and financial goals.

“Today’s report demonstrates the transformative power of providing patients access to high-quality primary care,” Greiner said. “That promise is only enhanced when primary care teams have access to the right support, tools and data. We’re grateful that Innovaccer and like-minded organizations are helping primary care-centric ACOs enhance the quality of care and generate record savings.”

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