What is the Medicare Shared Savings Program?
Established in 2012, the Medicare Shared Savings Program (MSSP) is one of CMS’ most successful value-based care models. In 2023, over 450 ACOs participated in this program, serving more than 10.9 million Medicare Fee-for-Service beneficiaries.
MSSP ACOs looking to take on more risk or new entrants to the MSSP market must leverage historical data to make informed decisions about financial benchmarking, quality reporting, and ongoing ACO participation and performance improvements.
Top-performing MSSPs Rely on CareJourney
CareJourney supported 122 MSSP participants in 2022, who generated nearly 25% of Centers for Medicare and Medicaid (CMS) total MSSP savings. ACOs rely on our solutions to help them assess participation in this program, build and grow provider networks, optimize provider performance, manage their MSSP patient population and uncover new expansion opportunities.
Assess Financial Benchmarks
Our VBC Model Benchmarking for Risk Bearing Entities is designed to help organizations evaluate opportunities in the MSSP and ACO REACH programs. Leveraging our vast experience with CMS Alternative Payment Models (APMs) and our 100% Medicare FFS claims data, we help you understand which model is a better fit for your network of providers based on claims-aligned benchmarks, performance year projections, and performance comparison analysis to ACOs in your region.
Uncover New Market/Growth Opportunities
By consolidating a variety of data sources and deriving market assessment insights, we help ACOs identify opportunities for growth both in existing and new markets. Our national claims database and over 300 episodes benchmarked help organizations identify high-performing providers across markets, evaluate market share by ACO, provider, practice group and health system, and surface benchmarks to guide peer-to-peer comparisons.
Optimize Model Performance
Our work with MSSP ACOs has helped us develop targeted actions that ACOs can easily implement to support network development, clinical, strategy, and operations teams:
- Network Development – Use trusted provider cost and quality metrics to build high-performing networks and channel care needs to the best providers.
- Care Coordination – Better manage at-risk populations and prioritize care gap closures, sharing patient lists with providers, or integrating data into patient profiles.
- Quality Improvement – Measure and monitor compliance with CMS’ quality requirements needed to qualify for shared savings.
- Care Retention – Track care being delivered outside preferred providers, steering to in-network providers and better coordinating patient care needs.
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