Care Management Programs
Expert articles and analysis related to care management programs.
AI Summary — Last 7 Days
Care management is moving toward more condition-specific, tech-enabled interventions tied to measurable outcomes: agilon is positioning its heart failure clinical pathway as a proactive VBC operating model for slowing disease progression, while Cigna is expanding AI-enabled chronic and complex care management across behavioral health, cancer, heart, kidney, and high-risk maternity populations with a projected $200M in savings over three years (Cigna expansion). In parallel, CMS under the Trump administration is broadening navigation coverage and proposing changes to RPM/RTM services, signaling continued federal interest in reimbursing longitudinal, non-visit-based support—but with operational tension around coding, documentation, and whether these services produce VBC-grade outcomes rather than incremental utilization (CMS RPM/RTM changes). For ACOs, payers, and physician groups, the week’s pattern is clear: care management is becoming less of a generic “coordination” function and more of a scalable, analytics-driven disease-management asset that must prove ROI, quality impact, and patient engagement.
Related Articles
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Cigna aims to save $200M in 3 years by expanding AI-enabled care management - beckerspayer.com
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