The Medicare Shared Savings Program generated $1.8 billion in savings for Medicare in 2022, the Centers for Medicare and Medicaid Services (CMS) announced Thursday. This is the sixth year in a row that the program created overall savings, and is the second-highest savings amount since the program started more than a decade ago.
The program creates savings by working with Accountable Care Organizations (ACOs), which are groups of physicians, hospitals and providers who work together to “provide coordinated, high-quality care to people with Medicare, focusing on delivering the right care at the right time while avoiding unnecessary services and medical errors,” CMS said. If an ACO is successful in improving care quality and saving health dollars, the ACO may be able to share in the savings it generates for Medicare. Shared Savings Program ACOs have more than 573,000 participating clinicians serving nearly 11 million Medicare beneficiaries as of January.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
“We are encouraged and inspired by six consecutive years of savings and high-quality care, with 2022 being one of the strongest years of performance to date,” said Meena Seshamani, MD, PhD, CMS deputy administrator and director of the Center for Medicare, in a statement. “The Shared Savings Program is Medicare’s permanent, flagship Accountable Care Program, and we look forward to continually improving and growing the program, expanding the reach of participating ACOs, and addressing critical health disparities across the country.”
When compared to clinician groups of a similar size not participating in the program, participating ACOs performed better on quality measures, including measures for diabetes, breast cancer and colorectal cancer screenings, tobacco screenings and depression screenings.
About 63% of the ACOs that participated in the program received payments in 2022. Low-revenue ACOs, or those that are “mainly made up of physicians and may include a small hospital or serve rural areas,” generated $228 per capita in net savings, CMS reported. High-revenue ACOs, meanwhile, had $140 per capita in net savings. Additionally, low-revenue ACOs made up of 75% primary care clinicians had $294 per capita in net savings.
Community Care of Brooklyn IPA (CCB IPA), a participating ACO in the program, announced Thursday that it earned $3.9 million in savings. This is the third consecutive year the organization has achieved shared savings. About 30% of CCB IPA’s members are dually eligible for Medicaid.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
“These results demonstrate that providers working with vulnerable patients and communities across Brooklyn can meaningfully and consistently succeed in value-based payment arrangements,” said Kishor Malavade, MD, CCB IPA executive director and vice chair of the Maimonides Department of Population Health, in a statement.
CMS is working to improve the Medicare Shared Savings Program, it added in its announcement. For example, in July it proposed “increasing the number of people receiving high-quality, accountable care by assigning more people who receive care from nurse practitioners, physician assistants, and clinical nurse specialists to ACOs,” CMS said.
“The Medicare Shared Savings Program helps millions of people with Medicare experience coordinated health care while also reducing costs for the Medicare program,” said CMS Administrator Chiquita Brooks-LaSure. “CMS will continue to improve the program, and it is exciting to see that Accountable Care Organizations are continuing to be successful in delivering coordinated, high-quality, affordable, equitable, person-centered care.”
Photo: StockFinland, Getty Images
