The Medicare Shared Financial savings Program generated $1.8 billion in financial savings for Medicare in 2022, the Facilities for Medicare and Medicaid Companies (CMS) introduced Thursday. That is the sixth yr in a row that this system created total financial savings, and is the second-highest financial savings quantity because the program began greater than a decade in the past.
This system creates financial savings by working with Accountable Care Organizations (ACOs), that are teams of physicians, hospitals and suppliers who work collectively to “present coordinated, high-quality care to individuals with Medicare, specializing in delivering the correct care on the proper time whereas avoiding pointless companies and medical errors,” CMS mentioned. If an ACO is profitable in enhancing care high quality and saving well being {dollars}, the ACO might be able to share within the financial savings it generates for Medicare. Shared Financial savings Program ACOs have greater than 573,000 collaborating clinicians serving practically 11 million Medicare beneficiaries as of January.
“We’re inspired and impressed by six consecutive years of financial savings and high-quality care, with 2022 being one of many strongest years of efficiency so far,” mentioned Meena Seshamani, MD, PhD, CMS deputy administrator and director of the Middle for Medicare, in a press release. “The Shared Financial savings Program is Medicare’s everlasting, flagship Accountable Care Program, and we sit up for regularly enhancing and rising this system, increasing the attain of collaborating ACOs, and addressing vital well being disparities throughout the nation.”
When in comparison with clinician teams of the same dimension not collaborating in this system, collaborating ACOs carried out higher on high quality measures, together with measures for diabetes, breast most cancers and colorectal most cancers screenings, tobacco screenings and despair screenings.
About 63% of the ACOs that participated in this system obtained funds in 2022. Low-revenue ACOs, or these which can be “primarily made up of physicians and should embrace a small hospital or serve rural areas,” generated $228 per capita in web financial savings, CMS reported. Excessive-revenue ACOs, in the meantime, had $140 per capita in web financial savings. Moreover, low-revenue ACOs made up of 75% main care clinicians had $294 per capita in web financial savings.
Group Care of Brooklyn IPA (CCB IPA), a collaborating ACO in this system, introduced Thursday that it earned $3.9 million in financial savings. That is the third consecutive yr the group has achieved shared financial savings. About 30% of CCB IPA’s members are dually eligible for Medicaid.
“These outcomes reveal that suppliers working with weak sufferers and communities throughout Brooklyn can meaningfully and constantly achieve value-based fee preparations,” mentioned Kishor Malavade, MD, CCB IPA govt director and vice chair of the Maimonides Division of Inhabitants Well being, in a press release.
CMS is working to enhance the Medicare Shared Financial savings Program, it added in its announcement. For instance, in July it proposed “rising the variety of individuals receiving high-quality, accountable care by assigning extra individuals who obtain care from nurse practitioners, doctor assistants, and scientific nurse specialists to ACOs,” CMS mentioned.
“The Medicare Shared Financial savings Program helps tens of millions of individuals with Medicare expertise coordinated well being care whereas additionally decreasing prices for the Medicare program,” mentioned CMS Administrator Chiquita Brooks-LaSure. “CMS will proceed to enhance this system, and it’s thrilling to see that Accountable Care Organizations are persevering with to achieve success in delivering coordinated, high-quality, inexpensive, equitable, person-centered care.”
Photograph: StockFinland, Getty Photographs
