Medicare Shared Savings Program Breaks Records
Amidst a barrage of news that always seems to have words like ‘burnout,’ ‘costs,’ or ‘staffing issues,’ it’s welcome to see some cause for celebration. Last week, the Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Shared Savings Program broke records in 2023, with more than $2 billion in savings realized. This figure was coupled with a more than $3 billion performance payment total for accountable care organizations (ACOs) that year, also a record.
ACOs are health organizations that agree to rigorous standards to control costs and provide extremely high-quality care for Medicare recipients. Organizations can be either incentivized or penalized depending on their costs and quality of care. Rather than trying to bill for as many procedures as possible to maximize revenue, ACOs avoid unnecessary procedures to reap the shared savings. The program’s efficiency, in turn, leads to lower out-of-pocket costs for patients.
The results weren’t just financial either, as CMS noted that ACOs were showing quality improvements and scoring better than other kinds of physicians groups in many metrics. These reported quality measures impact payments, so participating organizations have been eager to be better. The latest report shows that there were statistically significant improvements in the following categories:
- Diabetes and blood pressure control
- Breast cancer and colorectal cancer screening
- Future fall risk screening
- Depression screening and follow-up
- Statin therapy for prevention and treatment of cardiovascular disease
As of this year, there are 480 ACOs in CMS’ Shared Savings Program, which encompasses more than half a million clinicians. The success of the program, which now has reported seven straight years of savings, has led to some lofty goals; CMS wants everyone with Traditional Medicare to have an accountable care relationship by 2030.
The program moves forward with its digital initiatives as well, noting that the number of ACOs reporting all of the prescribed digital quality measures almost doubled in 2023, bringing the total to 72. CMS has proposed score tweaks for those organizations amidst a transition to these digital measures.
Higher quality care at a lower cost is an admirable goal and one that’s always exciting to see progress toward.
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