Medicare Shared Savings Program ACOs Saved $1.8B in 2022, CMS Reports

The Medicare Shared Savings Program (MSSP) saved Medicare $1.8 billion in 2022, with 63 percent of accountable care organizations (ACOs) earning payments for their performance.

This is the sixth consecutive year MSSP has generated savings and high-quality performance results, CMS said. The $1.8 billion also marks the second-highest annual savings since the program started in 2012.

“The Medicare Shared Savings Program helps millions of people with Medicare experience coordinated health care while also reducing costs for the Medicare program,” CMS Administrator Chiquita Brooks-LaSure stated in the press release. “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.”

In 2022, ACOs performed better on quality measures related to diabetes and blood pressure control, tobacco screening and smoking cessation, breast cancer and colorectal cancer screening, and depression screening and follow-up.

These results indicate that coordinated care provided by ACOs can help further the Biden Administration’s goals of improving behavioral healthcare services and boosting cancer screening rates and prevention.

Around 63 percent of ACOs participating in MSSP received payouts in 2022. ACOs that earned more shared savings tended to have low revenue. These ACOs are typically made up of physicians and may include a small hospital or serve rural areas.

Low-revenue ACOs saw $228 per capita in net savings, compared to $140 per capita for high-revenue ACOs. Low-revenue ACOs made up of 75 percent of primary care clinicians or more saw $294 per capita in net savings.

The results highlight how primary care contributes to the success of the MSSP. The National Association of ACOs (NAACOS) and other healthcare organizations have pushed for CMS to offer a hybrid primary care payment option in the MSSP. The ideal model would consider health equity, result in increased investment in primary care, be fully voluntary, and be available rapidly and in all locations.

In the calendar year 2024 Physician Fee Schedule proposed rule, CMS included changes to the MSSP aiming to encourage participation among healthcare providers and improve health equity in rural and underserved areas.

The agency proposed assigning more people who receive care from nurse practitioners, physician assistants, and clinical nurse specialists to ACOs. CMS also proposed changing the benchmark methodology to increase participation by ACOs caring for beneficiaries with high-cost, complex health needs.

As of January 2023, ACOs participating in the MSSP included more than 573,000 clinicians serving nearly 11 million Medicare beneficiaries. In 2021, the program generated $1.66 billion in savings for Medicare, with 58 percent of ACOs earning payments.