Research Alert: March 13, 2018

Medicare Accountable Care Organization Growth in Rural America, 2014-2016

Accountable Care Organizations (ACOs) are the most-widespread of the Centers for Medicare & Medicaid Services (CMS) value-based payment programs and demonstrations. Several ACO demonstrations have been released by CMS's Innovation Center, many modifying previous demonstrations, or building on demonstrations to be more inclusive of small and rural providers. As a result, ACOs have expanded broadly into rural areas, albeit with lower beneficiary attribution numbers than in urban areas.

Using CMS data on Medicare beneficiaries attributed to Shared Savings ACOs in U.S. counties for 2014-2016 we find that nearly every county (or equivalent) in the U.S. had at least one resident Medicare beneficiary attributed to an ACO in 2016. Over this period, there has been significant growth in ACO attribution in both metropolitan and non-metropolitan counties but the rate of growth in non-metropolitan counties has been substantially higher that in metropolitan counties.

Additional Resources of Interest:

• More information about the RUPRI Center for Rural Health Policy Analysis