ACOs continued to grow in size and count in 2017 and early 2018, according to an analysis from Leavitt Partners and the Accountable Care Learning Collaborative.
Here are four findings from their report, published in Health Affairs.
1. There were 1,477 ACO contracts at the end of the first quarter of 2018, spread among 1,011 ACOs. Contract counts include both public and private payer partnerships, and an ACO may have contracts with multiple payers. A total of 232 new ACOs were created in 2017 and the first quarter of 2018.
2. Forty-eight percent of ACO contracts are commercial, compared to 46 percent for Medicare. Medicaid accounts for just 5 percent of all contracts. However, Medicaid contracts tend to be much larger in terms of lives covered. The average Medicaid ACO covers 43,500 patients. Comparatively, the average commercial ACO covers 24,300 lives, and the average Medicare ACO covers 17,500.
3. ACOs covered 32.7 million patients across the country — roughly 10 percent of the U.S. population. At the end of the first quarter of 2018, ACOs covered about 2 million more patients than the year prior, representing 6 percent growth. ACOs can be found nationwide — at least 2 percent of the population in every state is part of an ACO — but they are not evenly distributed between or within states.
4. Medicare was the primary driver of ACO growth through the end of the first quarter of 2018. Commercial contracts saw little growth, and Medicaid contracts declined slightly. Medicare added 76 new two-sided risk contracts alone. These new contracts were in the Medicare Shared Savings Program Tracks 1+, 2 and 3, as well as the Next Generation program. Twenty-seven of these contracts involved groups that had never participated in an ACO program before. The authors said they believe the Quality Payment Program, which began in 2017, drove continued interest in Medicare ACOs, especially two-sided risk contracts, as they offered a viable way to enter the program's more lucrative track.
Read the full report here.