The Medicare Shared Savings Program Shaving Costs Across the Board

October 10, 2022

The Medicare Shared Savings Program offers plenty of affordable options for people who need medical treatment. Affordability is one barrier preventing a more significant number of Americans from getting the healthcare they need. Thanks to federal efforts, individuals meetings specific eligibility requirements have access to Medicare. This federal health insurance program can cover hospital stays, hospice care, certain physician services, and prescription drugs or vaccines.

The Medicare Shared Savings Program: What It Entails

There are different components to the Medicare system, and several healthcare providers, hospitals, and doctors work hard to keep costs low.

The Promise of Affordability

The goal of the Medicare system, including elements like Medicare Advantage, is to provide high-quality medical care at affordable rates. It can be hard to manage costs when factoring in the millions of people dependent on these services. Alternatively, the Centers for Medicare & Medicaid Services has delivered another year of exceptional services while saving money. The year 2021 saw a savings of $1.66 billion for Medicare, and the promise of the current Biden-Harris Administration to deliver affordable health care is coming true.

The Shares Savings Program is a coordinated care approach that benefits every facet of the health care system. Accountable Care Organizations work within this system and offer various value-based purchasing programs. Over half a million healthcare participants are in the program, delivering personalized care to more than 11 million people. Likewise, there may be plans to continue and extend the program throughout the industry and address the health disparities across the nation.

The Advantage to the Participants

The personalized services provided by the ACOs have had a remarkable impact on the health and wellness of participants. Patients in the program performed better on quality measures for issues like blood pressure, diabetes, and breast or colon cancer screenings. The response and results of depression screening and remission were also higher for patients working with an ACO clinician than those outside the program.

The Savings With Medicare Advantage

The Medicare system has saved money through strategic partnerships with ACOs, but the program offers significant savings to those enrolled. There are also supplemental plans to extend health care coverage and provide additional savings apart from what the original Medicare covers.

The Difference Between Regular Medicare and Medicare Advantage

Hospitals in the U.S. can treat anyone with essential healthcare services, and regular Medicare will cover the costs as long as it is under the insurance plan. There are no annual out-of-pocket expenses. However, Part B and Part D drug coverage requires a premium. 

There is a deductible and coinsurance for Part B as well. With Medicare Advantage, you must use an in-network provider for medical services and pay a premium for the plan and Part B. There are yearly limits on out-of-pocket costs, and most plans include drug coverage.

Cost savings are a huge concern for Americans needing healthcare. Affordability is a reality thanks to several good years of the Medicare Shared Savings Programs.

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