ECONOMIC REPORT OF THE PRESIDENT

Figure 4-25
Medicare Beneficiaries Aligned to ACOs, 2010–2016
Millions of Beneficiaries
10
9
8
7
6
5
4
3
2
1
2016
0
2010 2011 2012 2013 2014 2015 2016
Note: Beneficiary counts are for January of the year shown.
Source: Centers for Medicare and Medicaid Services.
states of Maryland and Vermont, CMMI is also testing statewide all-payer
initiatives aimed at making comprehensive changes in how providers in
those states deliver care.
In light of the potential of APMs to improve the performance of the
health care delivery system, the Administration set the goal of having 30
percent of traditional Medicare payments flowing through APMs by the end
of 2016, up from essentially none before the ACA. As illustrated in Figure
4-26, CMS estimates that this goal was reached ahead of schedule in early
2016. The Administration has set the goal of having at least 50 percent of
traditional Medicare payments flowing through APMs by the end of 2018.
Provisions included in the bipartisan MACRA will help accelerate
the Administration’s efforts to deploy APMs in Medicare. Under the law,
physicians who provide a sufficiently large fraction of their care through
“advanced” APMs will receive a bonus payment equal to 5 percent of their
annual Medicare revenue. Advanced APMs are a category that includes
most of CMS’ most ambitious APMs, including the two-sided ACO models
operating through the Medicare Shared Savings Program and CMMI,
several of CMMI’s bundled payment models, and the new Comprehensive
Primary Care Plus medical home model. Additionally, CMS has committed
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