Advanced Search

RECORDED WEBINAR: The GUIDE Model and What ACOs Are Missing: The Activated Family Caregiver as the Next Frontier in Dementia Strategy

 Download Slides The CMS GUIDE Model is bringing unprecedented visibility to the costs and unmet needs of persons living with dementia — and for ACOs, it’s revealing both a significant spend exposure and a significant strategic opportunity. The organizations moving fastest are recognizing what traditional care management models have overlooked: dementia is the one…

RECORDED WEBINAR: Spotting anomalous billing: An ACO case study

 Download Slides This webinar is for ACO and other healthcare leaders who have a growing concern that unscrupulous actors may be taking advantage of them and their patients. You will learn how HarmonyCares and their partner, HDAI, were able to identify and address serious issues in woundcare claims submitted by a small group of…

PacificSource and Ceresti Health Demonstrate Significant Cost Savings in Medicare Advantage Members Living with Dementia

CARLSBAD, Calif. and SPRINGFIELD, Ore., April 21, 2026 /PRNewswire/ — Ceresti Health, a national leader in tech-enabled dementia management, and PacificSource, an independent, not-for-profit community health plan serving the Northwest, today announce first year cost savings attributable to Ceresti’s dementia management program. Medicare Advantage plans are facing one of the most challenging financial environments in years as flat payment…

LEAD: Can CMS’ new model expand value-based care?

    CMS opens applications for new LEAD model In December, CMS announced a new Medicare accountable care organization (ACO) model called LEAD. The LEAD model replaces the ACO REACH model, which was originally introduced in 2022 and will end in December 2026. LEAD, which will begin Jan. 1, 2027, is a voluntary, 10‑year model designed to…

New Rural Funding Can Support Accountable Care Through Data And Digital Investments

Historically, policy makers have faced challenges implementing accountable care in rural communities. Rural facilities and delivery organizations can face financial challenges, workforce shortages, and financial volatility. Facility closures and limited clinician availability can constrain access and choice and lead to long patient travel distances. These factors make rural accountable care especially sensitive to infrastructure gaps. In turn, rural…

Your top questions on LEAD & MA changes — answered

This FAQ is based on our March 25, 2026 webinar “Taking the LEAD on CMS Policy Updates for VBC Excellence” and has been updated to reflect policy finalization through April 8, 2026. Note:‍ The application process for LEAD is expected to be competitive – meeting eligibility criteria does not ensure acceptance. Current ACO REACH PY 2026 participants may…

Getting Buy-in From Nephrologists to Participate in Alternative Payment Models

Evergreen Nephrology, which works with practices on value-based payment models for kidney care, operates across 24 states with a network of over 1,000 providers. Scott Lloyd, the company’s chief development & strategy officer, recently spoke with Healthcare Innovation about the importance of provider buy-in for value-based care. We were joined by Britt Newsome, M.D., M.P.H., chief medical…

LEAD the Way: An 8-Minute Primer on Accountable Care’s Next Chapter

In this episode, Gabriel Scott, Kevin Alonso, and Kennedy Caldwell break down the new Long Term Enhanced ACO Design (LEAD) Model and its impact on accountable care. They provide background on the model, outline key new features, and discuss five issues that Accountable Care Organizations and providers should consider as they evaluate participation. Listen to…

Medicare quality measures were capped even as most eligible doctors never reported them

New research from the Harvey L. Neiman Health Policy Institute found that most Merit-Based Incentive Payment System (MIPS) quality measures designated as “topped out” by the Centers for Medicare & Medicaid Services (CMS) were reported by only a small fraction of eligible physicians, suggesting these measures may not reflect consistently high performance across clinicians. Topped…

Making Cancer Support Services Sustainable in Value-Based Care

Over the past decade, the oncology community has generated a tremendous amount of evidence on the multitude of benefits of embedding supportive health care delivery interventions within clinical workflows of oncology providers.1-5 Despite the undeniable improvements in cost, quality, and patient experience, these programs, including formalized lay navigation and psychosocial support as well as proactive…

RECORDED WEBINAR: A Readmission Breakthrough: How Structured Insights Improve Transitions of Care and Close the Discharge Gap

 Download Slides Reducing hospital readmissions remains a central goal of value‑based care, yet many effective solutions are difficult to scale due to cost or operational burden. ilumed and Connective Health have pioneered a different approach that reduced hospital readmissions in Q4 2025 from 16% to 11% (27.5% reduction). By rethinking post‑discharge workflows, this program…

Load More