Care Management
Expert articles and analysis related to care management.
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CMS is moving care management further into technology-enabled, outcomes-based payment: the Innovation Center selected 150 participants for the voluntary ACCESS model, which will tie Medicare payment to chronic disease outcomes in obesity, diabetes, musculoskeletal pain, and depression—though its “lean” payment rates are testing whether digital health firms and providers can make the economics work at scale (ACCESS participants). At the same time, CMS’s proposed CJR expansion is pushing hospitals toward tighter post-acute coordination, including home health, signaling that episode-based and chronic-care models are converging around longitudinal care management infrastructure rather than isolated utilization control (CJR expansion). For ACOs, payers, and health systems, the strategic implication is clear: care management capabilities—digital engagement, outcome measurement, post-acute coordination, and practice transformation—are becoming core operating assets, but voluntary participation and lower-than-expected payments will favor organizations that can spread fixed costs across multiple VBC contracts.
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