Why Physician-Led ACOs Excel in the MSSP

Est. Reading Time: 3 Minutes

In 2012, the Centers for Medicare and Medicaid Services (CMS) launched the Medicare Shared Savings Program (MSSP). This visionary initiative introduced accountable care organizations (ACOs), spurred innovation, and accelerated value-based care’s momentum. Physician-led ACOs have proven particularly effective, generating nearly seven times more savings than other groups in the program.

See how Privia’s physician-led ACOs achieved shared savings of $131.7 million for the MSSP in 2022.

However, many doctors still underperform in — or avoid entering — the MSSP due to:

  • Overwhelming, incomplete, or disorganized data
  • Ineffective technology designed primarily for a fee-for-service model
  • Lack of cohesive physician governance

This episode explores how a partnership can help overcome these obstacles with Sam Starbuck, Senior Vice President and General Manager of Privia Quality Network, a physician-led ACO serving more than 80,000 beneficiaries, and William Cooper, MD, a board-certified internist at McIntosh Clinic, a multispecialty private practice in Thomasville, Georgia.

This excerpt of our conversation has been edited for length and clarity. You can listen to the full episode below and find us on Apple Podcasts, Google Podcasts, or your preferred platform

Dr. Cooper, I’m curious to hear your thoughts on McIntosh Clinic’s first foray into — and mixed results with — the MSSP before joining Privia. What challenges did you encounter that led you to seek a partner? And what made you consider — and ultimately decide on — Privia as a partner?

We knew pretty early on that value-based care was the future of medicine and that we wanted to be involved. Initially, we thought we could try to do that ourselves. But we quickly realized that the amount of information required was just overwhelming and disorganized. We just couldn’t make sense of it. Our first experience with an ACO was not a particularly successful one. We learned a lot though. What we learned was we needed an organization with the success, experience, and resources that we did not have: manpower, know-how, and technological infrastructure. That’s what really drew us to Privia. They allowed us to scale our aspirations, as it were. And it’s continued to be a great relationship.

Hear McIntosh Clinic CEO Mike Gebel discuss how Privia drives performance in both value-based and fee-for-service models.

How do Privia’s physician-led governance — especially our physician-organized delivery “PODs” — help doctors review data, foster constructive conversations, and make meaningful changes?

PODs, which are groups of local practices within the organization, create a culture of accountability through data transparency. You know, there are a few things that are true about physicians. We’re competitive and aspirational. We’re achievement-oriented box checkers. So sitting in a room with other providers,it’s helpful to have that transparency to compare yourself.

Read Sam Starbuck’s blog exploring how high-performance medical groups foster transparency and prioritize the doctor-patient relationship.

Privia’s access to information gives you the ability to know how you are doing in comparison to your peers. I like to call it “institutional peer pressure.” We hold each other to the fire. We hold each other accountable. That takes place at every POD meeting. I don’t think it would work any other way, really. It creates a desire to be the best we can.

In addition to local PODs, another unique element of Privia’s model is the ability to access data from different markets. Sam, how does Privia facilitate this cross-market collaboration?

As Dr. Cooper said, physicians are competitive. So how do we foster and facilitate that? There are formal ways. We have a great collaborative, the National Physician Advisory Council, where we bring physician leaders across the country together on at least an annual basis, if not semi-annually. It’s an opportunity to really highlight initiatives, successes, and trends across all of our markets and discuss what challenges we’re having and how we can improve.


That’s one of the formal structures we’ve put in place, but I think it’s the informal relationships that develop from those where the magic happens. Where lessons learned are shared. Conversations are had. Relationships are built. Honestly, that’s where I believe some of the best information sharing has occurred. It’s those informal avenues, those phone calls, and those networks that really drive cross-market pollination and connection.

If you’re thinking of transitioning to value-based care or looking for guidance, take advantage of the actionable information and advice in our free guide, Demystifying the Journey to Value-Based Care.

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