Protect the Providers. Protect the Seniors.

Save Medicare dollars, protect jobs, and maintain critical services for seniors.

 See The Nationwide Impact

In The News: REACH Is Delivering Savings—RTA Risk Corridors Put Those Gains at Risk

February 24, 2026
As the Center for Medicare and Medicaid Innovation’s most advanced accountable care organization (ACO) model, the ACO Realizing Equity, Access, and Community Health (REACH) model is demonstrating that sustained investment in transformative models of care can improve beneficiary health and reduce total cost of care. CMS’ performance year (PY) 2023 data show the model generates net savings, with savings increasing the longer organizations participate in the program.1 However, the growing success is being threatened by a benchmarking policy that would hold REACH participants financially responsible for inaccurate forecasting... Read the full article

Update

Working collaboratively with CMS, members of Congress, and other key stakeholders, we believe we are making meaningful progress toward mitigating the negative impacts of the RTA risk corridors for 2025. We remain committed to continuing this work, particularly on the significant unresolved issues related to waste, fraud, and abuse. We are encouraged by the strong support on Capitol Hill and the growing enthusiasm for value‑based care. We also appreciate CMS’s ongoing efforts and their commitment to addressing the challenges within ACO REACH and beyond.
While this progress is promising, substantial work still lies ahead. Independent providers will continue to feel the effects of similar systemic issues in 2026. It is critical that we remain focused on ensuring providers are not unfairly burdened by factors outside their control, including waste, fraud, abuse, and difficult forecasting environments.

The Current Situation

The Centers for Medicare & Medicaid Services (CMS) unintentionally underestimated healthcare costs. Now, primary care doctors will lose funding, and Medicare seniors could lose access to vital services.

In 2023, CMS implemented a policy called the Retrospective Trend Adjustment (RTA) Risk Corridors to protect Accountable Care Organizations (ACOs) from forecasting volatility. The policy didn't work as intended.

In 2025, CMS inadvertently underestimated costs by an estimated 10%, creating a budget shortfall. Instead of fixing the error, the RTA risk corridors force ACO REACH  participants to absorb the loss.

What's at Stake?

For Primary Care Practices

The typical primary care practice would lose roughly $155,000 in funding that directly supports Medicare seniors. That translates to losing an estimated $600 per ACO REACH patient for essential programs, resulting in additional Medicare spending as patients would lose access to care.

For Seniors

Seniors rely on no-cost services like care coordination, post-hospital follow-ups, and medication management. As practices are forced to cut programs, patients lose access to the care that keeps them stay healthy and out of the hospital.

For Doctors

ACO REACH practices operating on thin margins will be forced to cut patient services, lay off care coordination staff, or exit value-based Medicare programs entirely.

For Taxpayers

If independent providers can't trust CMS to pay shared savings fairly, excluding waste, they are not incentivized to participate in current and future CMS shared savings models. This reduces the savings generated by these doctors and puts the burden on the taxpayers.

The Remedies

Modifying/eliminating RTA risk corridors would:

  • Protect proven programs, like ACO REACH, that save CMS billions of dollars 
  • Save jobs and vital services for Medicare patients
  • Allow doctors to continue delivering cost-effective care
Addressing Waste, Fraud & Abuse

Particularly egregious fraud that concerns us:

  • Skin substitutions
  • Continuous glucose monitoring
  • Urinary catheters

CMS has the authority to change what providers are liable for, and what CMS takes responsibility for. Members of Congress can encourage CMS to take action to protect doctors and Medicare patients from these cuts.

For more information, or to discuss how you can help seniors, doctors, and primary care practices, email [email protected].

What Can I do?

Call CMS

  • Ask them to reduce the financial strain on providers and negative impact to patients by eliminating RTA risk corridors and addressing issues of fraud and waste in coding parameters.
  • Share your concern that not providing providers with their share of the savings they created will result in practices abandoning the program (and not participating in future programs like LEAD), driving up costs, and putting seniors' —and other patients'— health at risk.

Call the Office of Management and Budget

  • Share your concern that despite generating billions of dollars in savings now, independent providers nationwide may not be able to continue to participate in CMS's most successful taxpayer-saving models, including LEAD.
  • Share your concern that significant financial strains put on independent private practices will hurt their ability to generate savings in the future.

About Vytalize Health

Vytalize Health is a physician-led ACO REACH organization supporting independent primary care physicians across 30 states who serve over one million patients – we are one of many organizations facing this challenge. Vytalize has helped save CMS over $300 million through partnerships with independent community physicians. 

Share 0
Post 0