Medicare Advantage, accountable care organizations, and traditional Medicare: synchronization or collision?

Despite its size and immense influence over health care in America, Medicare today is no monolith. It is comprised of three distinct payment programs though which it provides services to beneficiaries: “traditional,” fee-for-service (FFS) Medicare; Medicare Advantage (MA); and the Medicare Shared Savings and Pioneer accountable care organizations (ACO) programs. These models, which strongly influence provider delivery arrangements and program costs, differ significantly along many dimensions important to beneficiaries and providers. In the wake of changes spurred by the Affordable Care Act (ACA) and the evolution of the health care delivery system, all three are evolving rapidly and subject to regulation that will affect their interaction with each other. It is not clear whether their paths will eventually cross and, if so, whether they will link together or collide.