Healthcare Innovation November 18, 2025
David Raths

HarmonyCares’ Will Robinson outlines how high-needs ACOs helped CMS identify and address huge spikes in wound care spending

Key Highlights

  • Skin substitute spending is projected to hit $15.4 billion for 2025, with many products costing over $1,000 per square centimeter and little clinical evidence supporting their use, according to HarmonyCares’ Will Robinson.
  • CMS is implementing new payment rules in 2026, capping reimbursement at $127 per square centimeter to address overpricing and misuse.
  • ACOs like HarmonyCares are leveraging claims data and care management strategies to try to prevent unnecessary or fraudulent use of high-cost wound care products.
  • CMS may consider policy tools such as stop-loss protections and rapid reporting channels to support ACOs in combating fraud, waste...

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Topics: ACO (Accountable Care), CMS, Govt Agencies, Insurance, Interview / Q&A, Medicare, Payment Models, Provider, Trends, Value Based
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