Estimated ACO numbers up to 520

Consulting firm Oliver Wyman’s ongoing tracking of the growth of accountable care organizations (ACOs) finds an additional 150 such payor-provider arrangements since its last report in July of 2013.

The New York-based firm combined government figures on Medicare and Medicaid ACOs with private-payor ACOs identified from press releases and news stories. Although many providers participated both governmental and non-governmental ACO programs, Oliver Wyman took care not to count organizations twice. Whether participating in one or more ACOs, each provider organization was only counted once, for an estimated total of 520 ACOs as of April of this year.

Because of this growth, more than two-thirds of the U.S. population now live in localities served by ACOs and more than 40 percent live in areas served by two or more. ACOs were most densely concentrated in the west coast states of California, Oregon and Nevada, the upper Midwest states of Minnesota, Wisconsin, Illinois and Indiana, and in Florida.

Most of the growth in ACOs came from the expansion of the government’s Medicare shared savings program and other new Centers for Medicare and Medicaid Services (CMS) ACO programs. The number of Medicare and Medicaid beneficiaries now served by an ACO rose by 32 percent since July of last year and by 120 percent since January of 2013.

However, non-Medicare ACOs also increased at a strong pace. Oliver Wyman's report cautioned that because there is no single registry or list of these organizations, as there is for Medicare ACOs, its numbers here are less precise. However, the firm's best estimate is that there are now 154 non-Medicare ACOs in the United States, compared to the 135 it counted in July of last year and the 124 it counted in January of 2013.

All total, Oliver Wyman’s report estimated that between 46 and 52 million patients, or roughly 15 to 17 percent of the U.S. population, now receive care under an ACO payment model. In addition, those not yet getting care under an ACO model may also be benefitting as providers typically make changes to their care delivery systems for all patients, not just those within the ACO.

“The rapid growth of ACOs is very encouraging,” said Niyum Gandhi, a partner in Oliver Wyman’s Health & Life Sciences practice and one of the firm’s experts on ACOs in a press release announcing the report. “But no one should be deceived: The process of shifting American healthcare to a new, sustainable model is nowhere near the finish line. On the other hand, these numbers mean we have a critical mass lined up at the starting gate."

Lena Kauffman,

Contributor

Lena Kauffman is a contributing writer based in Ann Arbor, Michigan.

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