Primary care helps Medicare’s Shared Savings Program achieve $2.1 billion in net savings

MSSP hits record savings: © WrightStudio - stock.adobe.com

The Medicare Shared Savings Program achieved over $2.1 billion in net savings for Medicare in 2023 — the largest savings in its decade-long history, according to the Centers for Medicare & Medicaid Services (CMS). In addition to cost savings, Accountable Care Organizations (ACOs) participating in the program have raised the bar in quality of care. With over 480 ACOs involved, the Shared Savings Program is now one of the largest value-based programs in the United States, including more than 608,000 clinicians who collectively care for nearly 11 million Medicare beneficiaries.

Primary care has emerged as a key factor in this success, as ACOs led by primary care clinicians demonstrated higher net savings per capita than other ACOs, according to CMS. This model underscores how primary care’s role in patient-centered, coordinated care leads to both better patient outcomes and reduced costs. “ACOs in the Medicare Shared Savings Program continue to deliver high-quality health care for people with Medicare and meaningful savings for the Medicare program,” said CMS Administrator Chiquita Brooks-LaSure.

ACOs in the Shared Savings Program earned $3.1 billion in shared savings payments in 2023, also a record high. ACOs that succeed in delivering high-quality care and reducing unnecessary spending are eligible to share these savings with Medicare. For patients, this has translated to fewer avoidable costs, including emergency visits, thanks to improved coordination and preventive care.

Quality improvements in chronic disease management

From 2022 to 2023, ACOs reported notable quality improvements in managing chronic conditions, including statistically significant progress in diabetes and blood pressure control, cardiovascular disease prevention, and cancer screening. These strides align with CMS’s broader Behavioral Health Strategy and Cancer Moonshot goals, highlighting the success of coordinated care in achieving critical national health targets.

CMS Deputy Administrator Meena Seshamani emphasized the program’s positive trajectory, stating, “We are encouraged by seven consecutive years of savings and high-quality care, with 2023 being the strongest year of performance to date.” She added that CMS is focused on expanding the program to ensure access to high-quality, affordable health care for all Medicare beneficiaries.

CMS pushes for digital advancements and primary care investment

The Shared Savings Program is also making strides in digital transformation, with 72 ACOs reporting all-payer digital quality measures in 2023, nearly double the number from the previous year. CMS is taking steps to support ACOs transitioning to digital measurement and proposes an adjustment to quality scores to account for the unique challenges complex organizations face in this shift.

Furthermore, CMS stated it is committed to strengthening primary care within ACOs, continuing to explore models that increase investment in primary care services.

Looking ahead, CMS has set a goal to bring all traditional Medicare beneficiaries under an accountable care relationship by 2030. Through rulemaking and the continued support of ACOs, CMS aims to expand the Shared Savings Program’s reach and ensure sustainable, high-quality care for all Medicare beneficiaries.