Texas ACOs Contribute to $1.6 Billion in Savings in Medicare Shared Savings Program
By Amy Lynn Sorrel

For the fifth straight year, the Medicare Shared Savings Program (MSSP), through its work with accountable care organizations (ACOs), generated significant savings and high-quality results, with Texas entities once again contributing to that success.   

The Centers for Medicare & Medicaid Services (CMS) announced $1.66 billion in savings in performance year 2021, with Texas ACOs earning more than $680 million of that savings.   

Nearly all ACOs – 99% – reported and met the quality standards required to share in those savings, including measures related to diabetes and blood pressure control; screening rates for breast and colorectal cancer and falls; flu vaccination; tobacco screening and smoking cessation; and statin therapy for the treatment and prevention of cardiovascular disease.  

Nationally, about 58% of participating ACOs earned incentive payments – a portion of the savings they helped generate – for managing health care costs while delivering high-quality care throughout 2021. This rate was higher among 39 of the 55 Texas ACOs that participated that year.  

Baylor Scott & White Quality Alliance led the nation in total savings, generating $124.5 million (an 8.94% savings rate) in the care of more than 125,000 patients with a 98.48% quality score.   

But large, integrated systems weren’t the only success stories. Twenty-seven ACOs considered “low-revenue” also generated savings. Two physician-led groups that got their starts with the help of the Texas Medical Association also touted success.   

In its fifth year of MSSP participation, East Texas Accountable Care Organization (ETACO) based in Nacogdoches achieved shared savings for the first time. With a 5.10% savings rate, ETACO saved $3.3 million in the care of 5,700 patients. The group also participates in commercial and Medicare Advantage value-based care contracts.   

The achievement is “a testament to the endurance of our doctors and the evolution of systems and processes by our care teams to make this possible,” said Kyle McMorries, MD, a Nacogdoches obstetrician-gynecologist and executive director of ETACO. With the help of TMA and other partners such as the Catalyst Health Network, the ACO has moved a majority of its patients into value-based care, “and from this, all of our patients have benefited. Many of our doctors were surprised in the savings, as they don’t feel like they did anything extraordinary. Value-based care has become their new standard of care, and in their minds, just good medicine.”  

Alliance ACO, a physician-led entity that includes a number of independent practices across South Texas, generated $5.4 million in savings (6.49% savings rate) with 6,154 Medicare patients in mostly rural communities. While Alliance has seen success in MSSP since 2017, the ACO underwent a complete reorganization in 2020 and continues to thrive.  

Over the past decade, MSSP has grown to one of the largest value-based purchasing programs in the country, although ACO participation has declined as federal regulations force groups to assume risk at a faster pace, says Kim Harmon, TMA associate vice president of innovative practice models. And while more than 11 million patients are currently covered under MSSP, the number of patients assigned to the program continues to fall as Medicare Advantage enrollment outpaces traditional Medicare fee-for-service.  

To promote participation, especially in rural and underserved areas, CMS proposed changes to the Medicare Shared Savings Program in the draft 2023 Medicare Physician Fee Schedule.   

TMA recently submitted comments on the proposed rule. Read Texas Medicine Today for updates on the final regulations, and visit the CMS MSSP webpage for additional information about the program.  

Last Updated On

September 09, 2022

Originally Published On

September 09, 2022

Amy Lynn Sorrel

Associate Vice President, Editorial Strategy & Programming
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Amy Sorrel

Amy Lynn Sorrel has covered health care policy for nearly 20 years. She got her start in Chicago after earning her master’s degree in journalism from Northwestern University and went on to cover health care as an award-winning writer for the American Medical Association, and as an associate editor and managing editor at TMA. Amy is also passionate about health in general as a cancer survivor, avid athlete, traveler, and cook. She grew up in California and now lives in Austin with her Aggie husband and daughter.

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