CMS Innovation Center’s Integration of Specialty Care Into Value-based Care Models
It may be a good time to consider a relationship with an ACO that participates in new federal payment models
What
The Center for Medicare and Medicaid Innovation (CMMI) is actively trying to promote value-based care models in Medicare and Medicaid. To accomplish this, CMMI outlined a strategy for specialty care a little over a year ago. The strategy centered around four key goals: (1) improve specialty care performance data reporting, (2) maintain momentum on acute episode payment models and conditions-based payment models, (3) create financial incentives within primary care for specialist engagement, and (4) create financial incentives for specialists to affiliate with population-based models (e.g., an accountable care organization [ACO]) and move to value-based care.
When
In April 2024, CMMI published a progress update on its value-based payment strategy. By 2030, CMMI plans to have 100% of traditional Medicare beneficiaries and most Medicaid beneficiaries enrolled in accountable care.
