Question Did spending for patients attributed to accountable care organizations (ACOs) differ from other patients enrolled in Medicare in the first decade of the Medicare Shared Savings Program (MSSP)? Findings In this difference-in-differences study of more than 8 million patients, ACO formation was associated with a mean differential reduction of $142 (1.2%) in annual per-patient spending over…
Adoption of value-based care (VBC) programs has continued to expand. For example, the share of healthcare payments from risk-bearing VBC programs where providers could lose revenue if they did not meet quality or cost goals reached 28.5% in 2023, up from 12.5% in 2019. Despite this steady growth, the Centers for Medicare and Medicaid Services (CMS) will…
The Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) program is designed to provide value-based care access, including home-based care, to underserved communities. New research shows that in its inaugural year, the program fell short of its aims. REACH beneficiaries have lower levels of social risk compared to the overall Medicare population,…
CMS is gearing up for the first mandatory bundled payment program in 2026 – is your organization ready for a bundled payment future? As the U.S. healthcare system continues its shift away from fee-for-service (FFS) toward value-based care (VBC), the prevalence of advanced alternative payment models is increasing. Bundled payments are attracting significant attention as…
In its first year, Medicare’s Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model fell short of enrolling providers that serve patients with high social risks, according to a new study published in JAMA Health Forum. Researchers of the study said that without further participation from these types of organizations, the program is…
First catheters, now skin substitutes—and more areas of anomalous medical billing will continue to pop up, requiring data vigilance and collaboration on the part of accountable care organizations (ACOs), according to speakers at the National Association of ACOs (NAACOS) Spring 2025 Conference. The identification of these areas potentially signaling fraud aligns with the Trump administration’s…
Artificial intelligence (AI) and value-based care (VBC) are both regarded as transformative forces within healthcare. They have the potential to supercharge precision medicine, curb skyrocketing healthcare costs, and deliver the experience and outcomes from healthcare that patients truly want. But beyond their shared promise, they also share the common issue of struggling to gain real…
Download Slides Join TCARE and Isaac Health for a webinar showcasing their partnership in the CMS GUIDE Model, which delivers comprehensive support for both individuals with dementia and their caregivers. Isaac Health provides expert-led dementia care, including personalized treatment plans, 24/7 telehealth access, and care coordination for patients. Meanwhile, TCARE supports caregivers with evidence-based…
A new partnership aims to strengthen accountable care models in health care practices around the country. AMGA, the American Medical Group Association, and Wilmington Health announced a partnership to start the AMGA Value Care Network. It is a new strategic initiative and collaboration to “deliver scalable solutions that empower AMGA member organizations to thrive in value-based care environments.” “We…
Will the U.S. healthcare system achieve a technological breakthrough, or will another promising tool die on the vine due to medicine’s illogical financial model? That was the question I set out to answer this morning from the main stage of the 10th annual Accountable Care Symposium in Orlando, Florida—an event hosted by Wellvana, one of…