Care Coordination & Referrals

Care coordination is being operationalized through more specialized, risk-bearing models: CMS’s ACCESS Model launch in July is positioning digital chronic disease management vendors around Medicare payment discipline, while ACO REACH participants are emphasizing improved care delivery and large-scale savings as evidence for continued accountable care expansion. At the same time, providers and payers are moving beyond generic referral management toward condition-specific networks—kidney care, MSK, home health, and CJR-X episodes—where governance, timely specialty evaluation, multidisciplinary support, and aligned incentives determine whether referrals reduce total cost or simply shift volume. The strategic tension for VBC stakeholders is whether these models can scale coordinated specialty access without underpaying enabling infrastructure, particularly as digital health companies adapt to CMS ACCESS economics and integrated systems test digital MSK and kidney care pathways ([AMA on CMS ACCESS](https://news.google.com/rss/articles/CBMiwgFBVV95cUxPdm0wY1I3d0IyR1UycEIxeGZZcWtaaDdrWDZpUEVXYVlWbHhSeHF2N20zRUNkU1pkTUE2NmtuV0p3TWtnUWl6cHJOOVM4elIwckZkQ0U2OWJiWklTTDVRbDFldTNDdkRKcjV3QmpQRWxHcFJEdllxbEpwdEhIdTJROVdCVV