On Jan. 1, CMS will begin implementation of a new alternative payment system for select hospitals. The Transforming Episode Accountability Model will hold participating hospitals responsible for the care quality, costs and post-acute coordination associated with five surgical procedures. The model is intended to mark a shift toward shared accountability and a test of whether healthcare providers…
The shift towards value-based care in senior living is continuing in 2025, driven by rising resident acuity, tight margins and payer expectations. As acuity drives changes in how operators manage their communities, senior living providers are more closely tracking health outcomes to show the benefit of the services they provide to keep people from moving “downstream” in…
As value-based care (VBC) continues to redefine reimbursement models and quality standards in skilled nursing facilities (SNFs), the Director of Nursing (DON) plays a central role — driving clinical excellence, operational efficiency and financial performance. With hospitals, health plans and VBC programs increasingly viewing SNFs as strategic partners, the DON’s influence is just as vital…
Download Slides Special Feature: Download Summary Article AI spending in healthcare and life sciences is projected to grow from $11.6 billion in 2024 to $19 billion by 2027, with a five-year CAGR of 16.6%, per Gartner. However, a majority of these investments have focused on Gen AI / LLMs which have delivered limited value…
It was another record year for the Medicare Shared Savings Program. The 476 accountable care organizations, or ACOs, participating in the program in 2024 saved over $6.5 billion, delivering care to 10.3 million Medicare beneficiaries. What’s more, the ACOs made significant improvements in key patient outcomes, particularly around prevention and chronic disease management. The 2024 financial and…
According to new CMS data, accountable care organizations (ACOs) saved Medicare $2.4 billion in 2024, setting a new record for savings in the Medicare Shared Savings Program (MSSP). At the same time, more healthcare organizations may be turning to value-based care to help them mitigate the impact of new policy changes, financial pressures, and more. Medicare ACOs set new…
Value-based care (VBC) continues to become a mainstream reality for health care providers. While a patient may not notice a difference between a value-based or a fee-for-service (FFS) approach, there is a stark difference for physician practices. It represents a complete paradigm shift. VBC is a necessary approach that allows physicians to care for the…
The transition from fee-for-service to value-based care (VBC) puts continued pressure on the healthcare industry, especially as organizations push to remain relevant in a competitive environment while improving patient outcomes. The primary goal of VBC is to enhance clinical results and reduce overall healthcare costs, aligning care delivery with the evolving expectations of payers and patients. Learning…
Collaboration, clinical evidence, data sharing and a focus on patient access are some of the critical things needed to provide those with cancer the best care while managing costs, say panelists at a session at the Pharmacy Benefit Management Institute’s annual meeting today in Orlando. This will be even more critical as new targeted, innovative…
In 2025, it’s harder than ever to access primary care in the United States, with patients now waiting an average of 31 days for an appointment — a 50% increase over the past two decades. A new Health Affairs Forefront article points to income disparities as a key factor in this trend. Specialists earn about $394,000 annually,…