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CMS just wrapped its Make Health Tech Great Again event at the White House, and it unveiled an ambitious new strategy to modernize how healthcare data is exchanged.

This time is different. We’ve heard similar promises before, but the administration plans to “stop theoretical debates and start delivering real results” by taking a two-pronged approach.

The first priority is establishing a CMS Interoperability Framework to enable seamless information exchange between patients and providers.

The second step is building a Health Tech Ecosystem to improve access to personalized tools so that patients have the resources they need to make better health decisions.

The CMS Interoperability Framework includes voluntary criteria for data sharing across different network types – health information exchanges, EHRs, and tech platforms.

The blueprint covers everything from patient and provider access to transparency and security, complete with implementation guidelines co-developed with the early adopters. It’s completely aligned with TEFCA, which CMS is still participating in.

Over 20 networks pledged to meet the criteria to become CMS Aligned Networks, such as delivering data through FHIR APIs, updating the national provider directory, and providing metrics on network queries for patient records.

The Health Tech Ecosystem is a “standards-based digital health environment” that will integrate apps, EHRs, and care delivery organizations with the new CMS Aligned Networks.

The ecosystem will leverage these integrations to develop new solutions for: (1) managing diabetes and obesity, (2) conversational AI to help check symptoms and navigate care, (3) “killing the clipboard” by replacing paper forms with digital solutions.

Over 30 companies and 11 major health systems signed on to “deliver results for the American people” by the first quarter of 2026, and the full roster includes some of the biggest names in healthcare.

The Takeaway

We apparently won’t have to wait long for the CMS Interoperability Framework and Health Tech Ecosystem to deliver results, although what those deliverables will look like remains to be seen.

CMS just released the Medicare Shared Savings Program results for 2022, and the report managed to drum up some serious debate on the effectiveness of MSSP despite last year’s record performance.

MSSP saved Medicare $1.8B in 2022, marking the sixth consecutive year of savings and the second-highest total since the program launched in 2012.

The program generates savings by working with accountable care organizations, or groups of providers who collaborate to cut down on avoidable utilization, duplicative care, and medical errors.

The ACOs that effectively improve care quality and reduce total spend are then able to share in that success, and 63% of participating ACOs were compensated in 2022.

Standout performers included Aledade (four of the top ten ACOs for overall savings rates) and Privia (delivered expenditures 8% lower than the median MSSP ACO), although results were mixed for other high profile participants like CVS.

CMS called out the fact that low-revenue ACOs comprised mostly of primary care physicians generated $294 per capita in net savings (vs. $140 per high-revenue ACO), underscoring the importance of primary care to the overall program.

Although at first glance those numbers make 2022 one of MSSP’s best years to-date, it’s worth noting that the total cost of Medicare over that time frame was a mammoth $747B.

That means that MSSP, the crown jewel of CMS value-based care programs that includes 482 ACOs equipped with some of the best care delivery tools in the industry, delivered an overall savings of just 0.24%.

That’s not to say that $1.8B is anything to scoff at, but it highlights the sheer size of the task at hand, and CMS devoted a healthy portion of the press release to proposed MSSP updates that would include more people who receive care from NPs / PAs and encourage ACOs to care for more medically complex beneficiaries.

The Takeaway

MSSP had a great 2022 by almost every metric, and the ACOs participating in the program are the tip of the spear for improving the country’s fractured health system. That said, it’s a long journey to lower overall costs even with $1.8B steps, and there’s still plenty of work to be done to help get there faster.

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