For risk-bearing ACOs, the shared savings (accrued through holding actual per-beneficiary spending below the benchmark) for an individual beneficiary may not cover the cost of providing some of the more expensive supports to the beneficiary on an in-kind basis. Research suggests that self-financing through shared savings is less likely to be a barrier for other less costly services, such as non-emergent medical transportation. A recent survey of ACOs revealed that 63 percent reported that their organization had only a “minor focus” on providing social services for attributed beneficiaries, although 95 percent of those ACOs indicated that it was “somewhat important” or “very important” that the ACO take the lead on addressing the social service needs of the populations that they serve. Of the ACOs that were surveyed, 89 percent indicated that lack of funding was a major barrier to addressing patients’ social needs.


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Line of Business or Market

Medicare ACOs