Medicare (Title XVIII of the Social Security Act)
Shared Savings Program

Shared Savings Program380

The Secretary will establish a shared savings program that promotes accountability for a patient population and coordinates items and services under Parts A and B, and encourages investment in infrastructure and redesigned care processes for high quality and efficient service delivery.381  Under such program, groups of providers of services and suppliers may work together to manage and coordinate care for Medicare fee-for-service beneficiaries through an Accountable Care Organization.382  Accountable Care Organizations that meet quality performance standards are eligible to receive payments for shared savings.383  The Accountable Care Organization must be willing to become accountable for the quality and overall care of the Medicare fee-for –service beneficiaries assigned to it384 and must define processes to promote evidence-based medicine and patient engagement, report on quality and cost measures, coordinate care such as through the use of telehealth, remote patient monitoring and other such enabling technologies385 and demonstrate to the Secretary that it meets patient-centeredness criteria, such as the use of patient assessments or individualized care plans.386 The Secretary will determine appropriate measures to assess the quality of care furnished by the Accountable Care Organizations,387 such as measures of clinical process and outcomes,388 patient experience of care,389  and utilization, such as rates of hospital admissions for ambulatory care sensitive conditions. 390  An Accountable Care Organization will submit data to the Secretary in order to evaluate the quality of care furnished by the Accountable Care Organization; such data may include transitions across health care setting, including hospital discharge planning.391  The Secretary will establish quality performance standards to assess the quality of care furnished by Accountable Care Organizations.392 The Secretary may incorporate reporting requirements and incentive payments related to the physician quality reporting initiative (S.S.A. §1848), including such requirements related to electronic health records and electronic prescribing.393