Care Coordination & Referrals
Expert articles and analysis related to care coordination & referrals.
AI Summary — Last 7 Days
Care coordination is moving from a “network management” function to a core VBC operating capability: CJR-X governance guidance is emphasizing tighter hospital–postacute alignment, while MSK models are pushing earlier specialty triage, digital care pathways, and wraparound services to reduce avoidable utilization and surgical spend. The clearest pattern is specialty integration into accountable care—MSK partnerships like Henry Ford Health/HAP/Protera’s model are pairing payer-provider data with coordinated digital clinical workflows, and ACO enablement vendors are positioning referral management, risk adjustment, and specialist engagement as prerequisites for downside-risk performance (HCTTF MSK case study). At the same time, proposed CMS physician payment shifts under the Trump administration could alter ACO–home-based care economics, intensifying the tension between directing referrals to high-value postacute partners and maintaining provider participation in Medicare risk arrangements (home-based care implications
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