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Estimated Savings From the Medicare Shared Savings Program.

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The Medicare Shared Savings Program (MSSP) showed losses in traditional Medicare but savings in Medicare Advantage, resulting in overall net savings for CMS. Its total budget impact remains uncertain.

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Area of Science:

  • Health economics
  • Healthcare policy
  • Medicare research

Background:

  • The Medicare Shared Savings Program (MSSP) is a key alternative payment model by CMS.
  • Understanding the MSSP's budgetary impact is crucial but not well-established.

Purpose of the Study:

  • To evaluate the association between the MSSP and net savings to CMS.
  • Analyze performance years 2013 to 2021 for budgetary impact.

Main Methods:

  • Economic evaluation using publicly reported MSSP data (2012-2021).
  • Incorporated estimates from two prior studies on traditional Medicare spending.
  • Estimated spillovers to Medicare Advantage (MA) by analyzing benchmark payment impacts.

Main Results:

  • MSSP associated with $584M-$1.423B net losses in traditional Medicare.
  • MSSP generated $4.480B-$4.923B in savings from MA benchmark reductions.
  • Overall net savings to CMS ranged from $3.057B to $4.339B (0.075% of combined spending).

Conclusions:

  • MSSP resulted in net losses to traditional Medicare and net savings to MA.
  • Overall net savings to CMS were observed, but the total budget impact is small and uncertain.
  • Challenges in estimating gross spending effects, especially recently, contribute to uncertainty.