The Medicare Shared Savings Program (MSSP), now in its sixth full performance year, is at a significant crossroads. In creating the MSSP, Congress envisioned that Medicare accountable care organizations (ACOs) could moderate Medicare spending and improve quality of care by providers taking greater responsibility for costs and quality. While MSSP ACOs have clearly improved the quality of care for Medicare beneficiaries, questions have been raised about whether the MSSP is actually costing Medicare more than it is saving. This has prompted Administration officials to suggest that changes are needed to accelerate MSSP ACO savings to the Medicare Program.
Department of Health and Human Services (HHS) Secretary Azar said in March that program “results have been lackluster,” and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma singled out one-sided risk ACOs for “increasing Medicare spending… encouraging consolidation in the market place, reducing competition and choice for our competition.” Verma concluded that “our system cannot afford to continue with models that are not producing results.”