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The Medicare Shared Savings Program (MSSP) is the largest value based care program from the Center for Medicare & Medicaid Services (CMS) to date. Since its inception in 2012, Accountable Care Organization (ACO) participation has doubled; providing care to over 10 million beneficiaries, generating $1.94 billion in total savings, and earning over $1.47 billion in shared savings in the latest 2019 performance year (PY).1 The purpose of this program is for ACOs to coordinate the following:
- Promote accountability for a patient population
- Coordinate items and services so patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors
- Encourage investment in high quality and efficient services
So, how can we map overall savings back to the goals of the program? Is there a formula for success ACOs can unlock to ensure top tier performance in MSSP?
The answers to these questions can be very complex given all of the contributing factors. ACOs need to consider not only the patient population they are serving, but the entire market including provider network selection, health system saturation, and geographic landscape.