Glossary term
Medicare Shared Savings Program (MSSP)
The Medicare Shared Savings Program is a CMS program that lets accountable care organizations share in savings when they meet cost and quality requirements for Medicare patients.
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What Is the Medicare Shared Savings Program (MSSP)?
The Medicare Shared Savings Program, or MSSP, is a Centers for Medicare & Medicaid Services program for accountable care organizations. An accountable care organization, or ACO, is a group of doctors, hospitals, and other health care providers that works together to coordinate care for Medicare patients.
The program is designed to reward ACOs that meet quality standards while lowering Medicare spending compared with a benchmark. Some ACOs can share in savings only. Others may also take on downside risk and owe money back to Medicare if spending is too high.
Key Takeaways
- MSSP is a Medicare program for accountable care organizations.
- ACO participants coordinate care for assigned Medicare fee-for-service beneficiaries.
- Shared savings depend on both cost performance and quality requirements.
- The program affects provider incentives, not a beneficiary's basic Medicare eligibility.
How MSSP Works
An ACO applies to participate in the program and enters an agreement with CMS. The ACO is measured against spending and quality benchmarks. If it performs well enough under its track, it may receive a portion of Medicare savings. If it participates in a two-sided risk arrangement, it may also be responsible for shared losses.
For patients, the program is meant to encourage better coordination, preventive care, and reduced duplication. A beneficiary generally keeps the freedom to see any Medicare-enrolled provider, although the ACO may try to improve communication among providers involved in the patient's care.
Program Mechanics
Program Element | What It Means |
|---|---|
ACO | Provider organization responsible for coordinating care |
Benchmark | Spending comparison point used to measure savings or losses |
Quality measures | Standards the ACO must satisfy to share in savings |
Shared savings | Payment to the ACO when requirements are met |
Shared losses | Repayment obligation under certain risk tracks |
What It Means for Medicare Beneficiaries
MSSP does not replace Medicare coverage. It changes how participating providers are organized and rewarded. A beneficiary may receive notices that a provider participates in an ACO, but the program is not the same as enrolling in a Medicare Advantage plan.
The practical question for patients is whether care feels more coordinated. That may show up through better follow-up, fewer repeated tests, clearer medication review, or more attention to chronic conditions.
The Bottom Line
The Medicare Shared Savings Program is a CMS value-based care program built around accountable care organizations. It tries to align provider incentives with lower Medicare spending and better quality, while preserving ordinary Medicare access rules for beneficiaries.