Download Slides The APP submission window is closed, and it is time for a debrief. If you’re like most, some aspects went well, but there are definitely opportunities for improvement. It’s likely that at least one of your measures suffered from a gap in documentation rather than a gap in care, and that others…
Download Slides The 2027 Medicare Advantage changes are already reshaping risk adjustment strategy. Subbu Ramalingam and Michael Lesnik break down what these changes mean in practice — why the documentation burden is increasing, which HCC coding approaches create risk, and where to focus now before the rules tighten further. This session covers the four…
Download Slides In this session, David Klebonis, President and COO-Palm Beach ACO, shares how they approached that problem: what broke down at scale, what they tried, and what changed when they moved from manual workflows to AI-driven execution. Zynix AI co-founder and MD Jay Chowdappa walks through the platform infrastructure behind those results and what it takes…
Download Slides AI and digital health tools are rapidly expanding across healthcare, but many organizations still struggle to use them in a way that improves care without losing the human connection. Leaders from Qubika, an AI and data infrastructure firm specializing in healthcare, and Avery Telehealth, a leading population health digital platform, will focus…
V28 is no longer a transition issue. It is the live operating environment for Medicare Advantage risk adjustment in 2026. CMS completed the three-year phase-in of the 2024 CMS-HCC model for CY 2026, meaning plans and providers are now operating under the full model rather than a blended version. That makes mid-year the right moment…
The accountable care organization (ACO) model is shaping up to be the base that future value-based care models will be built on, with more than 50% of Medicare fee-for-service (FFS) beneficiaries being aligned with an ACO now. While there’s a lot of room for improvement in the ACO model, the Centers for Medicare and Medicaid…
In many accountable care organizations (ACOs), frontline physicians are under strong pressure to schedule Medicare annual wellness visits (AWVs) for every eligible patient. On paper, AWVs are framed as a cornerstone of value‑based care. In reality, for patients who already receive regular, well‑designed chronic care and follow‑up visits, a separate AWV can easily become cost‑ineffective. It adds encounters and expense without…
Download Slides The Long-term Enhanced ACO Design (LEAD) Model is the CMS Innovation Center’s newest Accountable Care Organization (ACO) focused model, set to launch following the conclusion of ACO REACH at the end of 2026. LEAD builds upon the CMS Innovation Center’s earlier accountable care work and utilizes improved benchmarking to appeal to a…
Hemab Therapeutics and Seaport Therapeutics are the newest biotech companies to join the public markets, each with an upsized IPO. According to IPO research firm Renaissance Capital, April was the biggest month for biotech IPO proceeds in more than five years. The biotech IPO window looks like it’s reopening. This past week closed with three…
The year 2025 wasn’t easy for most ACOs struggling with the sudden transition to data aggregation. In fact, it was a trial by fire. ACOs joined the modern era of quality reporting in 2025 with APP (APM Performance Pathway) Reporting, which spurred aggregation from multiple practice systems and patient matching across the ACO. This required…
In time, value-based care will come to hospices, and they must be ready, according to Kent Anderson, CEO of Ohio’s Hospice. In this environment, scale will be key, as will a need to better understand the needs and objectives of referral partners, Anderson told Hospice News. He also leads Metta Health, a revenue cycle management…
Hard to resist the opportunity to go to a user conference that includes attending the F1 Miami race in Miami which also became the theme for the conference. The Garage’s recent user conference did just that as they leveraged some of the learnings from F1 racing to illustrate how they’re racing to enable value based…