Healthcare Program/Policy Evaluation Template (Word document

Healthcare Program/Policy Evaluation Analysis Template

Program or Policy Selected: Medicare Shared Savings Program (MSSP)

Describe the healthcare program or policy outcomes: The Medicare Shared Savings Program (MSSP) is a value-based payment model designed to incentivize healthcare providers to coordinate care and reduce costs for Medicare beneficiaries. The program rewards providers for achieving cost savings while maintaining or improving the quality of care. The primary outcome of the program is to reduce the cost of healthcare for Medicare beneficiaries while improving their overall health outcomes.

How was the success of the program or policy measured? The success of the MSSP was measured by analyzing claims data from Medicare fee-for-service beneficiaries. The program’s performance was evaluated using a variety of metrics, including total cost of care, utilization of healthcare services, and quality of care measures. Specifically, the MSSP measures outcomes related to beneficiary experience of care, care coordination and patient safety, preventative health, and the management of chronic conditions.

How many people were reached by the program or policy selected? The program is designed to reach all Medicare beneficiaries who receive care from participating providers. As of 2020, there were over 500 accountable care organizations (ACOs) participating in the program, serving over 10 million Medicare beneficiaries.

How much of an impact was realized with the program or policy selected? Since its inception in 2012, the MSSP has demonstrated success in achieving its primary goal of reducing healthcare costs while improving quality of care. ACOs participating in the program have consistently achieved cost savings, with total net savings to Medicare of $2.7 billion between 2013 and 2017. In addition, MSSP participants have demonstrated improvements in quality of care, with higher rates of preventative services, improved management of chronic conditions, and reduced hospital readmissions.

At what point in program implementation was the program or policy evaluation conducted? The MSSP program has been subject to ongoing evaluation since its inception in 2012. The Centers for Medicare and Medicaid Services (CMS) conducts regular evaluations of program performance and releases annual reports on program outcomes.

What data was used to conduct the program or policy evaluation? The program evaluation used data from Medicare claims, including information on healthcare utilization, cost, and quality measures. CMS also collects data on patient experience of care and conducts surveys of ACO participants to assess program effectiveness.

What specific information on unintended consequences was identified? One unintended consequence of the MSSP is the potential for providers to avoid high-risk patients, as they may be more costly to treat and could reduce the likelihood of achieving cost savings under the program. CMS has implemented risk-adjustment methods to account for this potential issue and has also encouraged ACOs to focus on improving care coordination and preventative care to improve outcomes for high-risk patients.

What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples. Stakeholders in the evaluation of the MSSP include Medicare beneficiaries, participating providers and ACOs, and CMS. Beneficiaries benefit from the program through improved access to preventative services and improved coordination of care. Providers benefit from the program through financial incentives and opportunities to improve quality of care. CMS benefits from the program through improved healthcare cost management and the ability to implement value-based payment models more broadly across the healthcare system.

Did the program or policy meet the original intent and objectives? Why or why not? Yes, the MSSP has met its original intent and objectives of reducing healthcare costs while improving the quality of care for Medicare beneficiaries. The program has consistently achieved cost savings and improvements in quality of care measures.

Would you recommend implementing this program or policy in your place of work? Why or why not? As a language model, I don’t have a place of work.