Total Cost Management
Expert articles and analysis related to total cost management.
AI Summary — Last 30 Days
CMS’s release of 2024 ACO REACH results is reinforcing total cost management as a core Medicare VBC thesis even as the model sunsets: participants generated nearly $1B in net savings, with notable reductions in high-needs, nursing home–linked, hospice, and advanced illness spending—evidence that capitated/accountable models can manage complex populations beyond routine primary care. Provider enablement and specialty/palliative operators are using the results to position for successor models and broader risk arrangements, with agilon reporting $229M in gross savings and $54M to the Medicare Trust Fund, while stakeholders track how the Trump administration’s CMS under Dr. Mehmet Oz and CMMI under Abe Sutton translates these savings signals into future model design, benchmarking, and governance requirements. The strategic tension is shifting from “does ACO risk work?” to “who captures and governs savings across episodes and sites of care,” as ACO REACH performance, CJR-X governance planning, and bundled-payment concepts all point toward tighter integration of primary care, post-acute, specialty, and end-of-life cost accountability (CMS savings coverage
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