TL/DR –
The Centers for Medicare & Medicaid Services (CMS) noted that Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP) achieved the highest rates of shared savings in 2024, with ACOs representing 80 percent of the 10.3 million beneficiaries earning performance payments of $4.1 billion and Medicare saving $2.4 billion. Notably, ACOs had higher savings per capita in 2024 compared to 2023, and ACOs composed mostly of primary care clinicians performed better, with lower utilization in areas like hospital discharges and Emergency Department visits. Aledade, a physician enablement company, reported that 93 percent of its ACOs earned shared savings, earning approximately $390,000 in shared savings per practice, and achieving over $585 in savings per beneficiary.
Medicare Shared Savings Program Reports Remarkable 2024 Performance
On August 28, the Centers for Medicare & Medicaid Services (CMS) declared the 2024 results from the Medicare Shared Savings Program (MSSP). They reported that 75% of the 476 Accountable Care Organizations (ACOs) achieved the highest rates of shared savings since the program’s establishment. These ACOs represent 80% of the 10.3 million beneficiaries and have amounted to performance payments totaling $4.1 billion. Medicare saved $2.4 billion, setting a record in the MSSP’s history.
Analysis of ACOs Performance
Compared to 2023, ACOs achieved higher savings per capita in 2024 at $241 versus $207 net per capita savings and $643 versus $515 gross per capita savings. Low revenue ACOs, typically led by physicians or FQHC/RHCs, performed better than high revenue ACOs, generating $316 versus $175 net per capita savings. ACOs with more primary care clinicians showed higher performance, and those that achieved shared savings exhibited lower hospital discharges, Emergency Department visits, and Skilled Nursing Facility stays.
Aledade’s Exceptional Results
Aledade, a Bethesda-based physician enablement company and nation’s largest network of independent primary care, reported remarkable results with 93 percent of their ACOs earning shared savings. The bulk of Aledade’s ACOs is comprised of primary care practices and community health centers nationwide, showing the effectiveness of value-based care in various geographical settings and patient populations. Furthermore, Aledade’s 10 CDC-only ACOs achieved over $585 in savings per beneficiary and earned a total of more than $96 million in shared savings in 2024.
Interview with Aledade’s CEO
In a recent interview, Aledade’s CEO, Farzad Mostashari, M.D., praised the MSSP for its contributions to quality improvements, access, and significant savings. He argued that the program is underappreciated despite its substantial benefits to patients, physicians, and taxpayers. He also emphasized the need for all traditional Medicare beneficiaries to be part of an ACO, portraying it as an alternative to Medicare Advantage. Mostashari further explained that ACOs achieve success through strong primary care applications, reducing hospitalizations and improving high blood pressure control rates.
Looking Forward for MSSP
Looking forward, Mostashari acknowledged the challenges posed by an aging population and the rising percentage of Americans living with chronic illness. Despite these hurdles, he expressed optimism about the MSSP’s continued advancement, emphasizing the need for policy support for primary care practices. He also called for the CMS to ensure greater predictability and simplify the program. Mostashari concluded that the actual savings from the MSSP are higher than reported and can help reduce cost growth.
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