Medicare Shared Savings Program Achieves Historic Savings and High-Quality Care in 2022

In a significant milestone for Medicare, the Centers for Medicare & Medicaid Services (CMS) has announced that the Medicare Shared Savings Program achieved remarkable results in 2022. The program not only saved Medicare $1.8 billion compared to spending targets but also maintained its commitment to delivering high-quality care. This marks the program’s sixth consecutive year of generating savings and producing exceptional performance results, making it one of the most successful cost-saving initiatives in Medicare’s history.


A Remarkable Track Record:

The Medicare Shared Savings Program has consistently demonstrated its ability to deliver substantial savings while upholding the highest standards of care. In 2022, it achieved the second-highest annual savings since its inception over a decade ago. This accomplishment showcases the program’s enduring impact on Medicare’s fiscal health and the well-being of its beneficiaries.


A Vision for Expansion:

HHS Secretary Xavier Becerra highlighted the program’s achievements, emphasizing its contribution of over $1.8 billion in savings and its delivery of high-quality healthcare to millions of beneficiaries. He also mentioned the administration’s commitment to expanding the program, especially in underserved communities, as a part of ongoing efforts to strengthen Medicare and make high-quality healthcare accessible to all.


Enhancing Coordinated Care:

The core of the Shared Savings Program is Accountable Care Organizations (ACOs), comprising doctors, hospitals, and healthcare providers collaborating to deliver coordinated, high-quality care to Medicare beneficiaries. These ACOs focus on providing appropriate care at the right time, reducing unnecessary services, and preventing medical errors. When ACOs successfully combine high-quality care with cost-effectiveness, they become eligible to share in the savings achieved for the Medicare program. This not only benefits Medicare’s financial sustainability but also reduces out-of-pocket costs for beneficiaries by better coordinating their care and minimizing avoidable healthcare utilization.


Expanding Access and Accountability:

Over the last decade, the Shared Savings Program has grown into one of the largest value-based purchasing programs in the United States. It links provider payments to improved performance and holds healthcare providers accountable for both the cost and quality of care. As of January 2023, the program includes more than 573,000 participating clinicians caring for nearly 11 million Medicare beneficiaries. In alignment with its success, CMS has set an ambitious goal: by 2030, 100% of Traditional Medicare beneficiaries will be part of an accountable care relationship.


Prioritizing Quality Measures:

ACOs participating in the program have consistently outperformed similar-sized clinician groups not in the program on quality measures. Notable achievements include higher performance in quality measures related to diabetes and blood pressure control, cancer screening, tobacco screening, smoking cessation, and depression screening and follow-up. This underscores how coordinated care can improve behavioral health treatment and contribute to achieving broader healthcare goals.


Support for Primary Care:

Low-revenue ACOs, often comprised mainly of physicians or serving rural areas, led the way in shared savings. They outperformed high-revenue ACOs, with low-revenue ACOs consisting of 75% or more primary care clinicians achieving the highest savings. This highlights the vital role of primary care in the Shared Savings Program’s success and demonstrates the program’s support for primary care providers.


Future Expansion and Improvements:

CMS continues to explore models and features to support Shared Savings Program ACOs in investing more in primary care services. The program’s growth and potential are further underscored by proposed changes in the CY 2024 Physician Fee Schedule. These changes aim to promote participation among healthcare providers, particularly in underserved areas, and enhance access to coordinated, efficient, and high-quality care delivered by ACOs to more Medicare beneficiaries.