Milliman: 5 Key Drivers of Savings in MSSP ACOs

1. An ACO’s benchmark year 3 (BY3) regional efficiency factor (defined as the ACO’s BY3 expenditures divided by the risk-adjusted expenditures in its region)
2. Having a benchmark significantly above costs in benchmark year 3 (BY3), the most recent benchmark year
3. ACOs that selected tracks with downside risk
4. ACOs with few specialists and hospitals on their participant lists
5. Higher rates of primary care evaluation and management (E&M) visits and lower rates of unplanned inpatient hospital admissions

Notes: From an article entitled, "What predictive analytics can tell us about key drivers of MSSP results: 2021 update," by Cory Gusland, Robbie Richards, Mackenzie Egan, and Anders Larson. The authors analyzed data from the 2019 performance year for ACOs in the Pathways to Success model (Pathways), referred to by CMS as “2019A.”
Source: Milliman, August 4, 2021
Source URL: https://www.milliman.com/en/insight/what-predictive-analytic...

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