Pathways to Success: Options for ACOs

The “Pathways to Success: Options for ACOs” white paper reports on predictions of the options available to current Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) under the recently finalized Pathways to Success rule.

Under the Pathways rule, ACOs will be designated either high or low revenue, based on claims data and practice revenues. This revenue determination will directly affect how quickly ACOs must take on downside risk. However, under the final rule, ACOs’ revenue status will not be known at the time they apply formally for the program.

Leavitt Partners’ research team used public and proprietary data sources to predict revenue status for 550 of the 560 currently active MSSP ACOs. The results show that 67% of current ACOs could potentially be designated high revenue. Furthermore, the study finds that individual ACOs cannot rely solely on characteristics like hospital leadership or ACO size to predict their revenue designation, as ACOs of all types were present in both the high and low revenue categories. It is unlikely individual ACOs will be able to fully understand the options that will be available to them under the Pathways program unless they conduct further analysis.