Download Slides In this 2026 measurement year, CMS’s sociodemographic status (SDS) risk adjustment is changing how medication adherence is measured, who you need to focus on, and why it matters more than ever. One in eight Medicare beneficiaries qualifies through disability rather than age, and this population underperforms across all three adherence measures by…
Nephrology occupies a uniquely strategic position in value-based care. Few specialties sit so directly at the intersection of clinical complexity, rising utilization, and outsized healthcare spend. Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are among the most resource-intensive conditions in Medicare, making kidney care one of the clearest opportunities for specialty-driven value creation….
When I think about what defines high-quality health care, I don’t start with a single visit or a specific service. I start with a broad view of the full care experience: how care is delivered over time, across settings and among care teams. High-quality care is built through coordination, prevention and a deep understanding of…
Medicare’s unprecedented and unpredictable spending growth in recent years is penalizing clinicians who have been most effective at slowing cost growth and improving care. The Accountable Care Prospective Trend (ACPT) in the Medicare Shared Savings Program (MSSP) could cost accountable care clinicians more than $700 million in lost shared savings for care delivered in 2025….
For nearly all acute care hospitals in the United States, a new mandatory payment model is on the horizon. The Centers for Medicare and Medicaid Services (CMS) has proposed the Comprehensive Care for Joint Replacement Expanded (CJR-X) Model, a mandatory, nationwide, episode-based payment model for lower extremity joint replacements (LEJRs) in Medicare fee-for-service (FFS). If…
Download Slides In the FY 2027 Inpatient Prospective Payment System (IPPS) and Long-Term Care Prospective Payment System (LTCH) Proposed Rule, CMS introduced CJR Expanded (CJR-X): a proposed nationwide, mandatory bundle payment model that would place every eligible acute care hospital at financial risk for 90-day lower extremity joint replacement (LEJR) episodes — with no…
The “alphabet soup” of new value-based care models from the Centers for Medicare & Medicaid Services (CMS) can be confusing and overwhelming for nursing home operators, but there are two models that should be on every provider’s menu: the Long-Term Enhanced ACO Design (LEAD) model and Transforming Episode Accountability Model (TEAM). Brian Fuller, managing director…
Download Slides TXAACOs 2026 brought together some of the nation’s leading minds in accountable care, healthcare innovation, population health, and value-based care. While attendees gained valuable insights from the conference sessions, many of the most important conversations happened between presentations, over dinner, in networking events, and in discussions among industry leaders throughout the week….
Download Slides Optimizing performance of value-based clinicians and addressing gaps in chronic care pathways are two major obstacles to helping patients achieve the clinical goals that improve outcomes and reduce utilization costs. Using an AI native-services solutions across the conditions that drive spend in a value-based organization, Altitude partners are effectively improving clinician performance…
This white paper explores how remote temperature monitoring can support earlier identification of inflammation before wounds develop, while helping reduce provider burden through structured patient outreach and staged intervention protocols. It also reviews the difference between research alert rates and real world implementation data, showing how proactive intervention and care management support can help streamline…
CMS finalized a new rule aimed at streamlining the No Surprises Act’s overwhelmed arbitration system. Provider groups largely welcomed the reforms — though some industry leaders said additional changes are still needed to address alleged misuse and improve transparency. The Centers for Medicare and Medicaid Services finalized a new rule on Thursday to improve the federal independent…
We started this series with a simple observation: The Value-Based Care world—for which your ACO was built—has greatly altered. ACOs now have a much bigger charge to manage specialty care for their patients and to adopt CMS tools to negotiate rates with high performance networks. The TEAM payment model is live and ACOs have a role….