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As in previous years, MSSP ACOs showed strong performance on quality of care measures. But many of the proposed reforms in the program center on whether a redesign could increase the modest savings that have been estimated by the Medicare actuaries and other researchers in the program to date. In this, the first post of a two-part discussion, we provide a summary and perspective on the MSSP results. In part II to be published tomorrow, we describe some potential implications for further reforms in the program, based on the factors associated with stronger performance, and the substantial variation in performance across individual ACOs.

Our analysis reflects ACO performance relative to their own spending benchmarks, set according to a regulatory formula that CMS is proposing to modify. Such a benchmark is not necessarily a measure of the savings that health care organizations would have achieved in …