Some early evidence reported in HealthAffairs indicated that geography, not size, is the key factor in success among Accountable Care Organizations of  participating in the Medicare Shared Savings Program.

In any event, of course, there will have to be more changes in the program for it to fulfill its creators’ hopes for hospitals across America

Fierce Healthcare summarized: ”The size of the ACO didn’t necessarily determine its likelihood of producing savings, as large ACOs ‘generally did not have an advantage in financial performance compared to smaller ACOs,’ according to the article.”

ACOs in the South outperformed  other regions’, and those in expensive areas were particularly successful in producing savings. The HealthAffairs study reported that “the way medicine is practiced (or at least has been practiced) in a region is important to the ACO’s ability to generate shared savings under current benchmarking methodology.”

”Financial performance, though, is only one part of ACOs’ overall mission, and the first HealthAffairs analysis notes that the savings produced by MSSP ACOs is not necessarily related to how they were able to improve the quality of care. ”