How Home-Based Care Helped The Medicare Shared Savings Program Generate $1.8B In Savings

The Medicare Shared Savings Program (MSSP) continues to save Medicare over a billion dollars annually.

And some of the highest-performing, most innovative Accountable Care Organizations (ACOs) participating in the program continue to generate savings by effectively using home-based care.

The U.S. Centers for Medicare & Medicaid Services (CMS) announced Thursday that MSSP saved Medicare $1.8 billion in 2022 compared to spending targets for the year. That marked the sixth-consecutive year the program generated overall savings and high-quality performance results, according to CMS.


“We are encouraged and inspired by six consecutive years of savings and high-quality care, with 2022 being one of the strongest years of performance to date,” CMS Deputy Administrator and Director of the Center for Medicare Meena Seshamani said in a statement. “The Shared Savings Program is Medicare’s permanent, flagship Accountable Care Program, and we look forward to continually improving and growing the program, expanding the reach of participating ACOs, and addressing critical health disparities across the country.”

Last year saw the second-highest annual savings accrued since MSSP started over a decade ago.

Nationwide, there are more than 450 MSSP ACOs. As of January 2023, those ACOs included over 573,000 participating clinicians who provided care to almost 11 million people with Medicare.


Moving forward, CMS has set a goal that 100% of people with fee-for-service Medicare will be part of an accountable care relationship by 2030.

“The Medicare Shared Savings Program helps millions of people with Medicare experience coordinated health care while also reducing costs for the Medicare program,” CMS Administrator Chiquita Brooks-LaSure said in the statement.

Approximately 63% of participating ACOs earned payments for their performance in 2022, according to CMS.

Of the high-performing MSSP participants over the last decade, several have turned to home-based care to boost outcomes and savings.

Baylor Scott & White Health saw a record year in 2020, for example, generating roughly $96 million in savings. The Texas-based health system has been a joint venture partner of home health, hospice and personal care company AccentCare since 2017.

That same year, Advocate Aurora Health’s three affiliated ACOs generated $110 million in savings. In explaining that success, Advocate pointed to the expansion of its Advanced Care at Home Program, which includes hospital at home and palliative care.

Meanwhile, Keystone ACO is another high-performing MSSP player. The ACO is a consortium of health care organizations and provider practices in central and northeast Pennsylvania. Led by Geisinger, at-home care services have continued to be a major part of its strategy.

A 2022 study into ACO strategies found that two-thirds of ACOs used some sort of home-visit activity. Home-based care approaches were used to better coordinate patient care, address social determinants of health (SDoH) and deliver higher-acuity care, among other uses.

“I think ACOs are growing more and more interested in home-based care and delivering it to their beneficiaries,” Rob Mechanic, the executive director for the Institute for Accountable Care and the study’s lead author, previously told Home Health Care News. “There’s been a lot of growth in the past three or four years.”

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