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The Medicare Value-Based Care Strategy: Alignment, Growth, And Equity

The Medicare Value-Based Care Strategy: Alignment, Growth, And Equity

July 21, 2022Douglas Jacobs, Elizabeth Fowler, Lee Fleisher, Meena SeshamaniHealth AffairsACO Development & CMS Application,Social Determinants of Health (SDOH),Medicare ACOs/MSSP,ACO Growth and Expansion

As the nation’s largest health care payer, responsible for more than one in five dollars spent on health care within the United States, Medicare plays a key role in transitioning the health care system away from fee-for-service, which incentivizes quantity of care, and towards value-based care, which incentivizes high-quality care and smarter spending. The passage of the Affordable Care Act served as a catalyst for innovative payment and care delivery models that reward better care, smarter spending, and health in all facets of life. Over the past decade, Medicare has made significant progress in moving towards value and advancing accountable care.

In Traditional Medicare, the Medicare Shared Savings Program brings together groups of doctors, hospitals, and other health care providers as Accountable Care Organizations (ACOs) to take responsibility for improving quality of care, care coordination, and health outcomes for groups of beneficiaries. The Shared Savings Program went from recruiting its first health care provider participants in 2011 to its current status as one of the largest value-based purchasing programs in the country, covering more than 11 million people with over 525,000 participating clinicians. Physician groups in the Shared Savings Program achieve higher quality ratings compared to their counterparts not in the program, and the program has saved the Medicare Part B Trust fund $6 billion dollars or more over the past five years.

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: health equity, Medicare, vbc

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