The Medicare Shared Savings Program (MSSP) is the largest federal initiative that promotes accountable care. Accountable care organizations (ACOs) represent groups of clinicians that take responsibility for patients’ health outcomes and costs. Evidence from MSSP shows that ACOs taking on downside risk have better cost and quality outcomes, but there is not currently a permanent…
All of us can see glaring issues with the healthcare system that need to be addressed — but system-level change is hard. The leap to VBC isn’t easy, but the results are undeniable. I practiced nephrology in eastern North Carolina for nearly 25 years. Like many of my colleagues, I went into medicine to give…
Sound Long-Term Care Management (SLTCM), an accountable care organization (ACO) participating in the Medicare Shared Savings Program, reported $113.985 million in total savings for performance year 2024, according to newly released results. The ACO, which focuses on long-term care and assisted-living populations, is among the facility-based groups showing substantial year-over-year savings as CMS continues to push for broader participation…
When the conversation shifts toward value-based care (VBC), hospital systems find themselves in a delicate balancing act. On one hand, VBC strategies compel providers to prioritize preventive, coordinated, and holistic care to improve outcomes and reduce avoidable acute care utilization. On the other, hospital systems are largely embedded in a fee-for-service (FFS) environment, where inpatient…
Download Slides Final Rule was released on October 31st! Are you dreading hundreds of pages of regulatory statute only to find that a few small sections of what was finalized actually relate to your ACO and/or practice? Let Patient360 clear the noise for you during this informative webinar session during which we will cover…
In late August 2025, CMS released Performance Year (PY) 2024 data for the Medicare Shared Savings Program (MSSP). MSSP incentivizes participants to provide coordinated, high-quality care while lowering costs by sharing a portion of savings achieved for Medicare with participants. This marked the twelfth year of the program and the eighth consecutive year MSSP has achieved savings…
Download Slides Emergency departments (Eds) across the United States are currently grappling with significant challenges. Widespread issues in emergency care—such as overcrowding, patient boarding, and mounting financial pressures—have created a cycle of strain that leads to far-reaching consequences for hospitals, patients, and health plans. As a result, EDs are overcrowded, patients face delays in…
In October the National Association of ACOs (NAACOS) and the Institute for Accountable Care published research showing that spending on skin substitute products for wound care is projected to reach $15.4 billion by the end of 2025, a 55% increase over 2024 spending. In response to outcry from NAACOS members and other organizations and a New…
The 2026 Medicare Physician Fee Schedule Final Rule is Here The 2026 Medicare Physician Fee Schedule (MPFS) Final Rule is out and you’re wondering what it means for you. It’s packed with finalized updates on MIPS, six new MVPs, easier ACO reporting, a new program model, and acknowledgment of the extensive feedback received on multiple…
You cannot control CMS raising cut points. But you can control how you respond. The 2026 requirements are clear. CMS is implementing risk-adjusted measures focused on Social Determinants of Health. The new Excellent Health Outcomes for All reward ties STAR ratings exclusively to performance among your hardest-to-engage members—Dual-Eligible, Low-Income Subsidy, and disabled populations. These changes…