A look at our 2025 Disease Burden Management Program

We’ve used data from our 2024 Disease Burden Management Program (DBM) and feedback collected from our ACN partners and providers to build our 2025 DBM Program. Here’s a look at what’s coming.

What’s new for 2025 DBM?

In 2025, we’re adding two new incentives to the program.

• The Clinical Suspecting Incentive: This incentive offers ACNs $2,500 per line of business if they can demonstrate the use of clinical suspecting for their eligible ACA and Medicare Advantage patients.
• The Coding Accuracy Incentive: This incentive offers ACNs $0.50 PMPM (per member, per month) if they achieve a coding accuracy score of 95% or greater in the documentation they submit for their eligible Medicare Advantage patients.

What’s staying the same?

All administrative details, requirements and incentives from the 2024 DBM program will carry over into 2025.

Want an in-depth review of 2025 DBM?

Check out our 2025 DBM webinar, located on the DBM webpage (behind login) and keep an eye out for the 2025 DBM Program manual, which will be released in December at the same time as our final PCP Incentive Program (PIP) manual.