Artificial Intelligence has profoundly impacted healthcare. Innovations in medical imaging and diagnostics, drug discovery and development, personalized medicine, surgery, virtual health, and predictive analytics lead the way.

Rural healthcare providers face unique challenges in providing care to the one in five Americans (67 million) who reside in rural, Tribal, or remote communities. The number of rural Accountable Care Organizations (ACOs) is growing to counteract hospital closures and buoy physicians experiencing lower reimbursement and greater responsibility.

The Centers for Medicare & Medicaid Services (CMS) created the Shared Savings Program (SSP) to encourage physician groups, hospitals, and other healthcare providers to support more coordinated, high-quality, and cost-effective care.

Accountable Care Organizations (ACOs) consist of groups of doctors, hospitals, and other healthcare providers who collaborate and coordinate care for groups of patients. Through performance-based payment models, ACOs share in the savings they attain with the primary goal of improving healthcare quality while reducing costs.

Care management service providers—the companies to which physicians and their practices outsource their programs—are becoming increasingly popular.

In 2020, the Centers for Medicare & Medicaid Services (CMS) finalized that auxiliary personnel, including contracted vendors or service companies, may perform Remote Patient Monitoring (RPM). This includes services described by CPT codes 99453, 99454, and 99457.

The Centers for Medicare and Medicaid Services (CMS) have updated the CPT code for the Social Determinants of Health (SDoH) assessment for 2025.

The Centers for Medicare and Medicaid Services (CMS) updated the CPT codes for Principal Care Management (PCM). For 2025, there were no major changes to the PCM program rules and regulations in CMS’s Final Rule.

Accountable Care Organizations (ACOs) can scale their patient cohort through care management, particularly through the Medicare Chronic Care Management program. But what are the most effective, research-based strategies ACOs use to maximize the value of Chronic Care Management?