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CMS just dropped its 2024 performance data for the Medicare Shared Savings Program, and the debate over the program’s true effectiveness rages on despite another record year.

MSSP saved Medicare $2.4B in 2024, the eighth consecutive year of savings and the highest total since the program’s inception in 2012.

The program generates savings by working with accountable care organizations to cut down on avoidable utilization, eliminate duplicative care, and minimize costly medical errors.

The ACOs that effectively improve care quality and reduce total spend share in the success, and last year saw 75% of participating ACOs earn $4.1B in performance incentives, a new all-time-high.

Accountable care delivers. MSSP ACOs lifted hypertension control rates to 79.5% in 2024 (up from 77.8% in 2023), while trimming the share of patients with poor hemoglobin A1c control to 9.4% (from 9.8%).

Low revenue ACOs (typically physician-led) continue to outperform high revenue ACOs (typically hospital-led), generating $316 in net per capita savings (vs. $175).

Most ACOs also performed better than comparable physician groups on quality measures, such as screening for depression and creating follow-up plans (53.5% vs. 44.4%).

There’s always a catch. Although at first glance 2024 was one of MSSP’s best years to-date, it’s worth noting that total Medicare spending also reached a staggering $847B.

That means that MSSP, the crown jewel of CMS value-based care programs that includes 476 ACOs equipped with some of the best care delivery tools in the industry, delivered an overall savings of just 0.28%.

$2.4B is nothing to scoff at, and the program is moving the needle, but it’s nowhere near fast enough to keep pace with Medicare’s runaway growth.

The Takeaway

MSSP had a great 2024 by almost every metric, and its ACOs are the tip of the spear for CMS’s push toward value-based care. That said, it’s a long journey to lower overall Medicare spending even with $2.4B steps, and there’s still plenty of work to be done to help get there faster.

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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