The Medicare Shared Savings Program saved Medicare $1.66 billion in 2021, the Centers for Medicare & Medicaid Services announced Tuesday. This is the fifth consecutive year the program has created savings.
The Medicare Shared Savings Program works with Accountable Care Organizations (ACOs), which are groups of physicians, hospitals and other healthcare providers. These ACOs collaborate to provide high quality care and avoid unnecessary services in a value-based purchasing model. By doing this and spending healthcare money wisely, the ACO may be able to share in the savings it achieved for the Medicare program. This differs from a fee-for-service model because it pays providers on the quality of care versus the quantity of services provided, which has led to skyrocketing costs.
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“We are encouraged and inspired by five consecutive years of savings and quality improvement,” said Meena Seshamani, CMS deputy administrator and director of the center for Medicare, in a news release. “Learnings from the Shared Savings Program can and should be applied across the industry, driving higher quality care system-wide.”
Nearly all participating ACOs, or 99%, met the quality requirements of the program to share in savings, and about 58% earned payments for their performance in 2021, CMS said. Low-revenue ACOs achieved $237 per capita in net savings, compared to high-revenue ACOs, which had $124 per capita in net savings.
“The type of ACOs that saw more net savings tended to be low-revenue, meaning they were mainly made up of physicians, included a small hospital or served rural areas,” CMS said.
Additionally, ACOs comprised of 75% primary care clinicians or more had $281 per capita in net savings, compared to $149 per capita in net savings for ACOs with fewer primary care clinicians.
“These results underscore how important primary care is to the success of the Shared Savings Program and demonstrate how the program supports primary care providers,” CMS stated.
ACOs in the program had better performance levels than groups not in the program, including better quality measures for diabetes and blood pressure control, breast cancer and colorectal cancer, falls risk screening rates and flu vaccination, CMS stated. The organization was not able to provide supporting data by the time of publication, however.
The program also benefited behavioral healthcare, as ACOs had better performance on depression screening and depression remission rates than those not in the program.
Aledade — which works with independent practices, health centers and clinics to build ACOs — said in a statement that its ACOs saved Medicare more than $390 million. Additionally, four of the top 10 performing ACOs in the program were with Aledade, said CEO Dr. Farzad Mostashari.
“Today’s news is a reminder that CMS’s goal to have every Medicare beneficiary in an accountable care relationship by 2030 is the right thing to do,” Mostashari said. “We need to get more physicians and patients into these payment models as quickly as possible. The results prove that it will mean better care and lower costs across the health care system. We’re honored to be a part of such important work with dedicated health care professionals all across the country.”
CMS is working to improve the Shared Savings program, announcing proposed changes earlier this year that would promote more participation, particularly among providers in rural and underserved communities. This includes giving advance payments to certain new ACOs in these areas to address social needs.
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