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Finalized Policies in the CY 2026 Medicare Physician Fee Schedule Final Rule

November 17, 2025Garrett SchmittCoding, HCC, MVPs, Risk adjustment coding

The 2026 Medicare Physician Fee Schedule Final Rule is Here The 2026 Medicare Physician Fee Schedule (MPFS) Final Rule is out and you’re wondering what it means for you. It’s packed with finalized updates on MIPS, six new MVPs, easier ACO reporting, a new program model, and acknowledgment of the extensive feedback received on multiple…

The future of hospital care is in your living room

November 13, 2025Garrett SchmittCCM, Chronic Care, HCC

With the government shutdown thankfully behind us, health systems can get back to business with some of the innovative programs that are producing great outcomes and satisfying patients. A growing number of Americans are receiving hospital-level care without leaving their living room, thanks to advanced technology and an evolving healthcare landscape that is delivering much…

RECORDED WEBINAR: What top ACOs are prioritizing for 2026: Expert Panel featuring Palm Beach, Pearl Health & More

November 11, 2025Garrett SchmittNo CommentsACO reporting, ACOs, APP, APP measures, eCQM, vbc, Webinar

 Download Slides Join an expert panel discussion exploring what top ACOs are prioritizing for 2026. Topics include the growing role of digital health and AI in reducing total cost of care, lowering readmissions, enhancing transitional care, and leveraging actionable ADT feeds for better outcomes. Panelists:• David Klebonis, CEO, Palm Beach ACO• Beau Munoz, MD,…

Reflections on 10 Years as a Long-Term Care ACO

November 6, 2025Garrett Schmittlong-term care, NAACOS

When it launched in 2016, Long-Term Care ACO was the first ACO to focus on the population of Medicare beneficiaries who reside in long-term care nursing facilities, but now several other ACOs have entered that space. At the National Association of ACOs (NAACOS) fall meeting, Kristen Krzyzewski, chief strategy and program development officer for LTC…

Accountable Care Organizations Deliver $6.5 Billion in Medicare Savings, Boosting Value-Based Care Momentum

November 4, 2025Garrett Schmitt

The Centers for Medicare & Medicaid Services (CMS) announced record results for the Medicare Shared Savings Program (MSSP) in 2024, marking its most successful year since the program’s launch over a decade ago. The initiative generated $6.5 billion in savings, underscoring continued momentum in value-based care and cost-efficient, coordinated healthcare delivery nationwide. Record Savings and…

How Value-Based Care Became Crossroads’ Dominant Model

November 4, 2025Garrett Schmitt

While deals in the substance use disorder treatment space have been slow over the past year, addiction provider Crossroads has had an eye on growth. Over the summer, the company completed a tuck-in acquisition of Family Health Services, expanding its reach in the Pennsylvania market. Today, the provider has more than 100 centers across nine…

Rapid Learning For Accountable Care Adoption

November 4, 2025Garrett Schmitt

Since its emergence more than two decades ago, participation in accountable care has become more established. In 2025, the Centers for Medicare & Medicaid Services (CMS) reported that more than half of Traditional Medicare beneficiaries are in an accountable care relationship. Considerable evidence indicates that patients benefit and costs are lower in coordinated, whole-person care models enabled by accountable care payment…

The 2026 CMS PFS Final Rule: The 5 Ways CMS Aims to Control Total Cost of Care

November 3, 2025Garrett Schmitt

The CMS PFS Final Rule is out . . . early? If you’re wondering how, in the midst of the Shutdown, a 2,375-page Rule could be released, the answer is simple: most of the proposals from this summer were finalized as is. There are always exceptions, but the big takeaway is that this Rule solidifies CMS’s proposals…

Medications: The Missing Link in Value-Based Care

November 3, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

For all the progress made in shifting the U.S. healthcare system toward value-based care, one of the most powerful levers for improving outcomes and reducing costs remains underused: medications. Medications influence every dimension of health outcomes. They prevent disease progression, reduce hospitalizations, and determine whether chronic conditions stay controlled or spiral into costly complications. Yet,…

The Overlooked Frontier Of Value-Based Care: Managing The Rarest, Sickest, And Most Expensive Patients

November 3, 2025Garrett Schmitt

For two decades, value-based care has been built upon a simple premise: if we better manage the sickest patients, total costs of care will fall. This idea catalyzed countless disease-management programs, care-coordination models, and technology innovations. And yet, as the field has matured, an inconvenient reality has emerged. Much of value-based care isn’t truly aimed at…

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Recent Posts

  • Finalized Policies in the CY 2026 Medicare Physician Fee Schedule Final Rule
  • The future of hospital care is in your living room
  • RECORDED WEBINAR: What top ACOs are prioritizing for 2026: Expert Panel featuring Palm Beach, Pearl Health & More
  • Reflections on 10 Years as a Long-Term Care ACO
  • Accountable Care Organizations Deliver $6.5 Billion in Medicare Savings, Boosting Value-Based Care Momentum
 
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