Medicare’s 2027 Shared Savings Program rule creates commercial opportunities - but the addressable budget is not the program’s gross savings. Here is the structure that matters.
The program covers roughly 12.6 million Traditional Medicare beneficiaries across 511 ACOs. A $1/member/month product is ~$151M in math. Penetration, channel costs, and self-service shrink the real number fast.
The rule creates 5 distinct business hypotheses: cost-sharing administration, ACO financial operating services, practice onboarding and participation history, quality evidence infrastructure, and rural/specialty delivery models.
The key insight: price from retained economics, not gross savings. A product that captures nearly all of a customer’s shared savings payment is not a viable vendor - it is an operating cost that crowds out the clinical work.
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