The Center for Medicare and Medicaid Innovation (CMMI) has come under increased political scrutiny for its demonstration programs’ frequent failure to produce savings for Medicare and Medicaid. These failures are surprising given that many demonstration projects are designed around care interventions that have evidence of achieving savings and reducing avoidable health care use. It’s important…

In many accountable care organizations (ACOs), frontline physicians are under strong pressure to schedule Medicare annual wellness visits (AWVs) for every eligible patient. On paper, AWVs are framed as a cornerstone of value‑based care. In reality, for patients who already receive regular, well‑designed chronic care and follow‑up visits, a separate AWV can easily become cost‑ineffective. It adds encounters and expense without…

The Center for Medicare and Medicaid Innovation (known as the Innovation Center) accountable are organization (ACO) models, which pay providers based on outcomes rather than services provided, have demonstrated an ability to drive gross savings while maintaining or improving quality. However, net savings directly to taxpayers (via Medicare once payments to ACOs are included) have been…