Physician participation in accountable care organizations (ACOs) reached a milestone in 2018. More than half of physicians reported their practice was part of an ACO.

  • Physician-led ACOs, which have led the Medicare Shared Savings Program (MSSP) in net savings per capita for years, continued their success by increasing last year’s (2017) per capita savings by 65 percent (to $114). Over 15 percent of these ACOs are in downside risk arrangements.
  • Larger ACOs do not necessarily perform better overall (although larger size may be beneficial for physician-led ACOs); physician-led ACOs achieve higher rates of shared savings and total net savings compared to hospital-based ACOs but have trouble staying in the program longer; and, having a lower benchmark makes it more difficult to achieve shared savings.

“Overall, 53.8% of physicians reported participation in at least one ACO type in 2018, up from 44.0% in 2016,” according to a released AMA research paper. By ACO type, 38.2% of physicians belonged to a Medicare ACO, 26.3% to a Medicaid ACO, and 39.0% to a commercial ACO.

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