Skilled Nursing News July 21, 2025
The time is ripe to reconsider an integrated ACO model for dually eligible patients, many of whom need nursing home care. Integration could happen via mandated relationships between Medicare ACOs and state Medicaid agencies, especially for plans serving a high number of dual-eligible beneficiaries.
Such a strategy could help the Centers for Medicare and Medicaid Services (CMS) achieve its goal with ACO REACH, in which a subset of providers would be designated as high-need ACOs that serve dual eligibles, according to an article published in Health Affairs.
Other strategies to promote more integrated Medicare ACOs would include models which support up-front investment and allow provider groups to reinvest savings over time, in turn unlocking barriers to participation.
But, the agency...
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