The last two years have dramatically strengthened the ACO role in providing accountable care. New CMS specialty payment models—TEAM, ASM, and the proposed CJR-X—each include specific provisions for ACO coordination and referrals, extending the ACO’s reach deep into the specialty care continuum. LEAD, the new long-term ACO model with prospective payments, has redefined the future […]
Beyond Payment Models: The ACO as a Hub for Patient Health
In our last four articles, we have focused on payment models and infrastructure to establish how ACOs can be central to Value-Based Care, even under specialty models. Now it’s time to shift our focus back to what the payment models set out to do: improve patient health and rationalize costs. We cannot lift up patient […]
The Technology Your ACO Needs to Thrive in the Shapeshifting Value-Based Care Future
We started this series with a simple observation: The Value-Based Care world—for which your ACO was built—has greatly altered. ACOs now have a much bigger charge to manage specialty care for their patients and to adopt CMS tools to negotiate rates with high performance networks. The TEAM payment model is live and ACOs have a […]
Can Your ACO Support the Future of Value-Based Care?
The year 2025 wasn’t easy for most ACOs struggling with the sudden transition to data aggregation. In fact, it was a trial by fire. ACOs joined the modern era of quality reporting in 2025 with APP (APM Performance Pathway) Reporting, which spurred aggregation from multiple practice systems and patient matching across the ACO. This required […]
How ACOs Can Manage Both Total Cost of Care and Episodic Payment Models
It’s a new world for ACOs, especially those just immersing in aggregated patient data. Once a rarity for ACOs to look beyond claims data for population health and analytics, ACOs are now finding themselves at the center of a data need surge. The transition from easy, manual quality reporting for a sample of ACO patients […]
What TEAM and ASM Tell Us About the Future of Value-Based Care
In the last year, CMS has made strides to revamp health care through Medicare and Medicaid, taking some controversial steps. But one of their more positive moves involves changes to their Value-Based Care strategy. So, what does that strategy—through new or restructured payment models—tell us about where the system is headed? TEAM, ASM, ACCESS and […]
Why ACOs Should Create High-Performance Specialty Networks
Specialty costs have been a difficult problem for ACOs, driving a huge portion of total costs in specialty-driven services of all kinds: physician visits, hospital admissions, procedures, and treatments. ACOs have argued they don’t have the tools needed to combat costs. But that is not quite true. We argued in a recent webinar that ACOs […]
The 2026 CMS PFS Final Rule: The 5 Ways CMS Aims to Control Total Cost of Care
The CMS PFS Final Rule is out . . . early? If you’re wondering how, in the midst of the Shutdown, a 2,375-page Rule could be released, the answer is simple: most of the proposals from this summer were finalized as is. There are always exceptions, but the big takeaway is that this Rule solidifies […]
Three Strategies for ACOs to Optimize Specialty Care through TEAM
Both the greatest strength and weakness of the ACO shared savings (MSSP) model is its focus on primary care, particularly chronic disease. ACOs have put patients with diabetes, hypertension, and other conditions usually handled through primary care physicians at the center of care coordination, population health, and care management. But as CMS Value-Based Care’s central […]
Curate Your Data to Tackle Cost of Care: Master These Basics
The staggering reality that health care could soon account for one fifth of all domestic spending has put a bull’s eye on health care cost control. Is your ACO, health system, or physician organization ready to manage the coming congressional budget cuts? The only effective way to tackle Total Costs of Patient Care (TCoC) without […]