Eliminating the impact of RTA Risk Corridors will help save Medicare dollars, protect jobs, and maintain critical services for seniors.
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.
The Current Situation
In 2023, CMS implemented a policy called the Retrospective Trend Adjustment (RTA) Risk Corridors to protect Accountable Care Organizations (ACO) from forecasting volatility.
In 2025, CMS inadvertently underestimated healthcare 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.
What’s at Stake 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 healthy and out of the hospital.
What’s at Stake 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.
The Remedy
- Protect proven programs like ACO REACH that save CMS billions of dollars annually
- Save jobs and vital services for Medicare patients
- Allow doctors to continue delivering cost-effective care
Who Can Make This Change?
CMS has the authority to change the RTA risk corridors policy. Members of Congress can encourage CMS to take action.
For more information, email[email protected]
About Vytalize Health
Vytalize Health is a physician-led ACO REACH organization supporting independent primary care physicians across 30 states. Vytalize has helped save CMS over $300 million through partnerships with independent community physicians.
Leave a Reply