Medicare Shared Savings Program reaches historic milestone: $2.1B in net savings

The Centers for Medicare & Medicaid Services (CMS) reports the net savings in 2023 is the largest savings in the Medicare Shared Savings Program’s history.

In addition to saving Medicare more than $2.1 billion in 2023, CMS said that accountable care organizations (ACOs) in the program earned shared savings payments of $3.1 billion, the highest since the program’s inception more than 10 years ago.

ACOs in the program are groups of doctors, hospitals, and other health care providers who collaborate and provide coordinated, high-quality care to people with Medicare, focusing on delivering the right care at the right time while avoiding unnecessary services and medical errors. When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it may be eligible to share in the savings it achieves for the Medicare program. ACOs may also share in losses if they increase spending. CMS said this also drives lower health care costs for people with Medicare, who see lower out-of-pocket spending on avoidable health care use, such as emergency department visits, because ACOs deliver better-coordinated, whole-person care.

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In 2023, ACOs led by primary care clinicians had significantly higher net per capita savings than ACOs with a smaller proportion of primary care physicians. CMS said the results underscore the importance of primary care to the success of the Shared Savings Program.

From performance year 2022 to 2023, ACOs’ performance improved on quality measures they are required to report to share in savings, including significant statistically significant improvement on quality measures related to diabetes and blood pressure control, breast cancer and colorectal cancer screening, screening for future fall risk, statin therapy for prevention and treatment of cardiovascular disease, and depression screening and follow-up.

CMS said the quality improvements by ACOs show how this type of coordinated, whole-person care can improve treatment of common conditions, including behavioral health and cancer, helping to the agency’s behavioral health strategy goals and improve cancer screening rates and preventions, which is in line with the Cancer Moonshot goals.

The Shared Savings Program is one of the largest value-based payment programs in the country. As of January, 480 Shared Savings Program ACOs include more than 608,000 clinicians who provide care to nearly 11 million people with Medicare. Based on the program’s record success and opportunities to continually improve value for people with Medicare and the health care system, CMS has set a goal that 100 percent of people with traditional Medicare will be part of an accountable care relationship by 2030. 

“We continue to be encouraged and inspired by seven consecutive years of savings and high-quality care, with 2023 being the strongest year of performance to date,” said Meena Seshamani, M.D., Ph.D., CMS deputy administrator and director of the Center for Medicare, in the announcement. “We are taking steps to continue to grow this impactful program to ensure those we serve have access to high-quality, affordable health care, no matter where they live.”