Accountable Care Organization Efficiency on Entry and Shared Savings Bonuses

Are less efficient accountable care organizations (ACOs) in the Medicare Shared Savings Program more likely to earn bonuses compared with more efficient ones?In this cross-sectional study of 402 ACOs between 2013 and 2020, less efficient ACOs on entry more commonly earned bonuses compared with more efficient ACOs. Following the introduction of the regional benchmark adjustment in 2017, there was no significant narrowing of this gap.These findings suggest that the Shared Savings Program preferentially rewards less efficient ACOs compared with efficient ones, even after the introduction of the regional benchmark adjustment.

Corresponding Author: Arnav Srivastava, MD, MPH, MS, Dow Division of Health Services Research, Department of Urology, University of Michigan, 2800 Plymouth Rd, Building 16, Ann Arbor, MI 48109 (srivasar@med.umich.edu).

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