On August 28, officials at the Centers for Medicare & Medicaid Services (CMS) announced results from the Medicare Shared Savings Program (MSSP) for performance year 2024. There was good news. As CMS noted in publishing a fact sheet on that date, “For Performance Year (PY) 2024, ACOs in the Shared Savings Program achieved the highest rates of shared savings since the inception of the program. Out of 476 ACOs, 75 percent of ACOs, representing 80 percent of the 10.3 million assigned beneficiaries, are earning performance payments totaling $4.1 billion, and Medicare saved $2.4 billion relative to benchmarks. PY 2024 had the highest share of ACOs receiving performance payments and the highest amount of savings for ACOs and Medicare since the inception of the Shared Savings Program."Further, CMS officials noted on that date, “ACOs had higher savings per capita in PY 2024 compared to PY 2023, $241 vs $207 in net per capita savings and $643 vs $515 in gross per capita savings, respectively.  Net per capita savings represent the savings for Medicare, whereas gross per capita savings are the savings shared by ACOs and Medicare. Low revenue ACOs continue to outperform high revenue ACOs, generating $316 vs $175 net per capita savings. Low revenue ACOs are typically physician-led ACOs or are comprised of FQHC/RHCs, while high revenue ACOs are typically hospital-led. ACOs composed predominantly of primary care clinicians performed better compared to ACOs with fewer primary care clinicians, with $401 vs $219 in net per capita savings. ACOs that achieved shared savings had lower utilization compared to their benchmark across many categories of utilization including hospital discharges, Emergency Department visits and Skilled Nursing Facility stays,” the agency noted.Meanwhile, leaders at the Bethesda, Md.-based Aledade, a physician enablement company that describes itself on its website as “the nation’s largest network of independent primary care,”  were able to tout results even better than the average among the MSSP-participating ACOs nationwide. They noted on their website that “Aledade’s network, composed of primary care practices and community health centers across the nation in rural, suburban and urban settings, demonstrated that paying for value instead of volume is better for primary care and patients. A remarkable 93 percent of Aledade ACOs earned shared savings, compared to 73 percent of non-Aledade ACOs across the entire MSSP. Aledade’s ACOs earned approximately $390,000 in shared savings per practice. Aledade’s effectiveness across various geographies and patient populations is further highlighted by the fact that its network includes more than 25 percent of all community health centers (CHCs) in MSSP. These organizations face unique challenges serving beneficiaries in underserved communities, requiring additional dedicated resources and innovative approaches to help them reach this level of success,” they said.Highlights included that Aledade’s 10 CDC-only ACOs “achieved over $585 in savings per beneficiary, +38 percent year over year,” and “earned a total of more than $96 million in shared savings in 2024, +62 percent year over year.Per all this, Farzad Mostashari, M.D., CEO of Aledade, spoke recently with Healthcare Innovation Editor-in-Chief Mark Hagland about Aledade’s excellent results, and where the program goes from here. Below are excerpts from their recent interviewIt sounds as though these results have been all good news for Aledade’s groups, in the MSSP?

That’s right, and beyond Aledade, I want to rise in praise of the Medicare Shared Savings Program, which I really think is a gem. I think it really is underappreciated.CMS put in its fact sheet, more than $4 billion dollars in savings, better quality and access, lower use of EDs, quality that’s improving faster year over year, and billions of dollars in payments to primary care doctors. That’s just the fact sheet. And what other programs have we seen in Medicare that delivered more benefits to patients, not fewer, more payments to physicians, and saved the taxpayers money? And the only way you can achieve all three things is to reduce bad things happening to patients, reduce hospitalizations, etc. In 30 years of health policy, I’m not aware of a program that has been able to do all three of these things.As the CMS actuaries noted in June, the U.S. healthcare system is expected to go from the current $5.6 trillion in total U.S. healthcare expenditures to $8.5 trillion in the next eight years Many are still not fully aware of the power of this formula, correct?You’re correct. And we don’t have a lot of tools in the toolkit to manage rising costs. And it is time—and I will say to their credit, what I’ve heard from Dr. Oz, from Chris Clomp [Deputy CMS Administrator, and Director, Center for Medicare & Medicaid Innovation], who heads the Center for Innovation, is that they want everyone in traditional Medicare to be in an ACO—they’re actually seeing ACOs as an alternative to Medicare Advantage. If a senior wants to be in coordinated care through managed care, great; if they want to be in coordinated care through an ACO, that should be an option. And health plans can deny claims, can require prior authorization, can restrict the network, can put in place benefit designs where people have to pay higher copays. ACOs can do none of those things. We can’t limit care, deny care, or raise copays. We have to do it through giving patients more, not less. And that’s the beauty of this program, in the win-win-win that it creates.You and your colleagues just saved Medicare a billion dollars. Walk me through the mechanics of that process.It really is just the strong applications of good primary care. Our partner practices—over 2,000 of them—are community-based primary care practices. And for the first time, they’re actually rewarded for keeping patients healthy and out of the hospital, through primary care. One statistic: the MSSP rates of blood pressure control are up to 79 percent. The historic number given was that only 65 percent of patients with high blood pressure had it controlled. And it’s now risen to 79 percent. And in Aledade, we’re at almost 84 percent.

Just really, really good care management, correct?