MSSP Continues to Deliver Meaningful Savings and High-Quality Health Care

Program Saves Medicare More Than $2.1 Billion in 2023, the Largest Savings in its History

The Centers for Medicare & Medicaid Services announced that the Medicare Shared Savings Program (Shared Savings Program) continues to save Medicare money while supporting high-quality care. The Shared Savings Program yielded more than $2.1 billion in net savings in 2023 — the largest savings in the Shared Savings Program’s history. In addition, Shared Savings Program Accountable Care Organizations (ACOs) are providing higher-quality care and supporting policies CMS has adopted to enhance primary care, expand access to accountable care to underserved communities, and prioritize quality care for common chronic conditions.

In 2023, ACOs in the Shared Savings Program earned shared savings payments (also known as performance payments) totaling $3.1 billion, the highest since the program’s inception more than 10 years ago. In addition, ACOs scored better on many quality measures than other types of physician groups and continued to demonstrate quality improvement. ACOs led by primary care clinicians had significantly higher net per capita savings than ACOs with a smaller proportion of primary care clinicians. These results continue to underscore how important primary care is to the success of the Shared Savings Program.

“Accountable Care Organizations in the Medicare Shared Savings Program continue to deliver high-quality health care for people with Medicare and meaningful savings for the Medicare program,” said CMS Administrator Chiquita Brooks-LaSure. “CMS continues to improve the Medicare Shared Savings Program for the future so that providers in Accountable Care Organizations are able to deliver coordinated, high-quality, affordable, equitable, person-centered care to people with Medicare.”

ACOs 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, the ACO may be eligible to share in the savings it achieves for the Medicare program. ACOs may also share in losses if they increase spending. This also drives lower health care costs for people with Medicare, who see lower out-of-pocket spending on avoidable health care utilization, such as emergency department visits, because ACOs deliver better-coordinated, whole-person care.

From performance year (PY) 2022 to PY 2023, ACOs’ performance improved on quality measures they are required to report to share in savings. This includes 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. Improvements in quality performance by ACOs underscore how this type of coordinated, whole-person care can improve treatment of common conditions, including behavioral health and cancer, helping to achieve CMS’ Behavioral Health Strategy goals and improve cancer screening rates and prevention, in line with the Cancer Moonshot goals.

Over the past decade, the Shared Savings Program has grown into one of the largest value-based payment programs in the country. As of January 2024, 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% of people with Traditional Medicare will be part of an accountable care relationship by 2030. CMS is also continuing steps to further strengthen the Shared Savings Program.

“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, MD, PhD, CMS Deputy Administrator and Director of the Center for Medicare. “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.”

As articulated in a recently published article, CMS continues to explore testing models and adding new features via rulemaking to support Shared Savings Program ACOs in increasing investment in primary care services. ACOs also continued to adopt digital quality measures with 72 ACOs reporting all payer measures in PY 2023, nearly double the number of ACOs from the previous year. CMS is taking action to support ACOs, helping them report digital quality measures, including a proposal in the Calendar Year 2025 Medicare Physician Fee Schedule Proposed Rule to establish an adjustment to an ACO’s quality score to account for the challenges complex organizations face as they transition to digital measures. CMS will continue to work with ACOs to overcome barriers to adopting digital quality measurement reporting.

View more information on the Medicare Shared Savings Program.

View more information on the proposals for the Medicare Shared Savings Program in the CY 2025 Physician Fee Schedule proposed rule or reference the Shared Savings Program Fact Sheet.

View the 2023 Medicare Shared Savings Program Financial and Quality performance results.