Dive Brief:
- The Medicare Shared Savings Program, a value-based care purchasing initiative that aims to link provider payments to cost and quality, saved Medicare $1.8 billion last year, according to the CMS.
- That marks the sixth consecutive year the program has generated overall savings, and it’s the second-highest annual savings for Medicare since the MSSP launched in 2012.
- About 63% of participating accountable care organizations earned payments for their performance last year, and ACOs that earned more shared savings tended to have low revenues, according to the agency.
Dive Insight:
ACOs under the Shared Savings Program are groups of healthcare providers who work together to provide coordinated care to Medicare beneficiaries, avoiding unnecessary services, medical errors and avoidable utilization to lower spending.
In 2022, low-revenue ACOs saw $228 per capita in net savings, more than high-revenue organizations with $140 per capita. Low-revenue ACOs made up largely of primary care clinicians saw $294 per capita in net savings, according to the CMS.
Organizations in the program include more than 573,000 clinicians who care for almost 11 million people insured under the federal program geared toward seniors. Earlier this year, the agency said three of the government’s accountable care programs — which includes MSSP, ACO REACH and Kidney Care Choices — will cover more than 13.2 million people this year.
The CMS wants all traditional Medicare beneficiaries to be in an accountable care relationship by 2030. Earlier this year, CMS proposed updating the MSSP to include more people who receive care from nurse practitioners, physician assistants and clinical nurse specialists as well as changing benchmark methodology to encourage ACOs to care for medically complex beneficiaries.
Proponents of the program say the agency’s report shows that the government should double down on ACOs. The National Association of ACOs argued Congress should encourage participation in MSSP and other value-based care models by extending incentive payments for risk-bearing ACOs.
“Every year, the body of data on how ACOs are improving our fragmented health system grows, and this year is no different,” Clif Gaus, president and CEO of NAACOS, said in a statement. “ACOs continue to provide more of what patients want and deserve — affordable, high-quality, coordinated and personalized care.”
But participation in MSSP has fallen over the past several years. Participation peaked in 2018 with 561 organizations, and data from the CMS shows 482 ACOs were included last year. According to a release from January, 456 are participating in the program in 2023. The CMS argues changes from a recent payment rule will boost growth in the program.
