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Health systems and ACOs: Prepare yourself for the return to cost containment as the central objective of Value-Based Care in 2025. While cost measures have always been part of CMS Value-Based Care quality programs, their impact was small relative to the total MIPS score for physician groups. Likewise, ACO savings look big in dollars but comprise only a few percentage points of total Medicare spending. All that is about to change.
In short, cost-cutting is the new administration’s top priority, and the track record on Value-Based Care cost control is not good enough to resist budget crunching. ACOs are the largest Value-Based Care program of the federal government, but they can’t show proof of their impact on total Medicare spending due to program particulars. The Congressional Budget Office (CBO) projects a small increase—not decrease—in federal spending for Center for Medicare and Medicaid Innovation (CMMI) payment models from 2023-2033, even as it suggests that savings should subsequently accumulate.
The new administration ran on a platform that called for change, less government, and tax cuts. Improving access to care or health equity is no longer the focus.