Medicare Shared Savings Program Continues to Grow and Deliver High-Quality, Person-Centered Care Through Accountable Care Organizations
Today, the Centers for Medicare & Medicaid Services (CMS) released data showing that Accountable Care Organizations (ACOs) are serving a growing patient population, according to CMS’ annual summary of the Medicare Shared Savings Program, which is Medicare’s national ACO program. CMS projects that over 11 million people with Medicare will be served by Shared Savings Program ACOs in 2022.
“With one in every five health care dollars paid by Medicare, we can strengthen and transform our health care system,” said CMS Administrator Chiquita Brooks-LaSure. “Accountable Care Organizations present an invaluable opportunity to move Medicare toward person-centered care.”
CMS is announcing that 66 new ACOs joined the program and 140 existing ACOs renewed their participation for a new agreement period starting January 1, 2022. This brings the total number of ACOs in the Shared Savings Program to 483 in 2022. As of January 1, 2022, over 11 million people with Medicare receive care from a health care provider in a Shared Savings Program ACO, up 324,000 (3%) from the previous year.
ACOs are groups of doctors, hospitals, and other health care providers that join together voluntarily to provide coordinated, high-quality care and ensure that people with Medicare receive the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO may be eligible to share in the savings it achieves for the Medicare program. In certain instances, an ACO may owe a portion of losses if it increases costs or does not meet certain quality metrics.
“Over the last decade, Medicare has promoted participation in value-based care to reward better care, smarter spending, and improved outcomes,” said Meena Seshamani, MD, PhD, CMS Deputy Administrator and Director of the Center for Medicare. “CMS’ commitment to value-based care has never been stronger. As we continue working toward our goal of increasing the number of people in a care relationship with accountability for quality and total cost of care, we celebrate this increase in ACO participation, and know we have more work to do.”
ACOs are an important innovation for moving CMS' payment systems away from paying for volume and towards paying for value and outcomes. ACOs are held accountable for spending and for quality performance, including performance on outcome and patient experience measures, and support integrated care for Medicare beneficiaries by ensuring that their health care providers work as a team.
ACOs’ work to coordinate care and improve quality enabled them to better respond to the pandemic. They were able to quickly transition to using telehealth to provide critical access to care and are providing essential team-based services to address the full spectrum of issues arising from the pandemic.
The number of Shared Savings Program ACOs that are in a track that qualifies as an Advanced Alternative Payment Model (APM), where health care providers can receive additional rewards for delivering high-quality and cost-efficient care in return for taking on higher levels of risk, increased from 34% to 50%. CMS is encouraging health care providers to participate in these payment arrangements.
To view Shared Savings Program fast facts, visit: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/program-data
To view Public Use Files, visit: https://data.cms.gov/medicare-shared-savings-program/accountable-care-organizations