Blog

Justice-involved individuals (JIIs) reentering society often face a complex mix of challenges: Chronic health conditions, mental health and substance use disorders, unstable housing, limited job prospects, and a deep distrust of systems. The first 90 days after release are critical. Without solid, coordinated care, many fall through the cracks increasing the likelihood of adverse health […]

The Center for Medicare and Medicaid Services (CMS) recently issued a notice announcing changes to the ACO REACH for Performance Year 2026. The ACO REACH currently is projected to conclude at the end of 2026, but there is ongoing speculation around a potential expansion. CMS’ intent of these changes is to improve model sustainability by […]

Federally Qualified Health Centers (FQHCs) play a critical and innovative role in delivering comprehensive care to underserved communities, yet they face ongoing challenges in sustaining financial health and operational efficiency. With Medicaid and Medicare margins tightening from rate increases lagging behind inflation, proactive strategies are essential for sustainability. This article explores 5 key strategies that […]

Introduction:: Federally Qualified Health Centers (FQHCs) serve as an essential access point for uninsured, underinsured and high-need patients, and are uniquely positioned to address both primary care and health-related social needs (HRSNs) of underserved populations. Because of their mission of serving those who may otherwise not have access to care, FQHCs historically have focused […]

As California’s CalAIM initiative and the broader healthcare landscape continue shifting toward value-based care (VBC), Enhanced Care Management (ECM) providers must prepare to be successful. ECM’s emphasis on social determinants of health, preventative care, and care coordination aligns with Managed Care Plans’ (MCPs) evolving priorities and incentives to drive improved health outcomes and lower the […]

California’s healthcare landscape is undergoing a significant transformation with the integration of Community-Based Care Management into Dual Eligible Special Needs Plans (D-SNP) under the CalAIM initiative. The shift aims to enhance care coordination for individuals eligible for both Medicare and Medi-Cal, aligning with the principles of Value-Base Care (VBC).   What is CICM?: California […]

As we approach the Medicare Shared Savings Program (MSSP) Phase 1 application period for Performance Year (PY) 2026, now is the time to take stock of how changes in the Medicare policy environment affect current and prospective Accountable Care Organizations (ACO). For a more detailed review of application timeline and strategic considerations, refer to our […]

CMS has indicated that the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model is moving forward, and the pre-implementation period is well underway in awarded states Maryland, Connecticut, Vermont, Hawaii, Rhode Island, and downstate New York. AHEAD is a voluntary total cost of care model whereby CMS encourages a state-level, multi-sector approach to […]

MCP practices should consider and begin to plan for a transition to enter the MSSP ACO program for 2026 and choose stable, long-term partners to take control over your VBP future. There are two primary ways to enter the MSSP ACO program for 2026 If you separated from an MSSP ACO in 2024, you could […]

The recent news that CVS Health is exiting the Medicare ACO space, fully withdrawing from ACO REACH and selling its MSSP business to Wellvana: , highlights the ongoing challenges faced by ACO aggregators. While these organizations often position themselves as enablers of value-based care (VBC), their long-term sustainability remains uncertain, creating potential risks for providers […]