Medicare Shared Savings Program (MSSP)

The Medicare Shared Savings Program (MSSP) offers providers and suppliers (e.g., physicians, hospitals, and others involved in patient care) an opportunity to create an Accountable Care Organization (ACO). An ACO agrees to be held accountable for the quality, cost, and experience of care of an assigned Medicare fee-for-service (FFS) beneficiary population. The Shared Savings Program has different tracks that allow ACOs to select an arrangement that makes the most sense for their organization. In return for cutting down on Medicare costs, the ACO will receive a percentage of the generated savings. This opportunity allows ACOs to get extra revenue from doing their jobs better.

On the downside, if an ACO does not decrease Medicare’s costs, but instead increase it, that ACO will have to pay for the extra incurred costs. This may not seem like much, but if costs are slightly increased for all the Medicare patients in the ACO, the payment will add up fast. With this model, Medicare is shifting their priorities to “making sure that patients get the best care possible, and keeping them healthy and out of the hospital.”

[MSSP] is an alternative payment model that:

  • Promotes accountability for a patient population.
  • Coordinates items and services for Medicare FFS beneficiaries.
  • Encourages investment in high quality and efficient services.
- Center for Medicare and Medicaid Services

MSSP ACO Analytics Software

In order to help ACOs find the right balance between “cost effective” and “the best care possible,” analytics software companies have been created to handle the numerical and non-medical side of Medicare. In our case, Synergy Infoconnect works closely with ACOs enlisted in the MSSP to break down individual patient costs and figure out how ACOs can lessen them. Since Synergy works with a plethora of experienced physicians, we are able to provide generalized care plans for multiple illnesses. This allows ACO doctors to quickly reference a plan and then make changes to specialize it for their patients. Unlike other ACO analytics companies, at Synergy Infoconnect we like to provide ACOs with the best tools available because we want all Medicare beneficiaries to get the best treatment possible.

For more information on MSSP, please refer to these sources: