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How ASCs can reach their value-based care goals

July 14, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

The transition to value-based care may seem daunting for many healthcare leaders, especially those who operate independently and have less margin for error when it comes to implementing new systems and initiatives. Flagler Health is a technology company offering AI tools and other advanced technologies to streamline many aspects of patient care for medical practices….

RECORDED WEBINAR: Key Concepts in IDD Health Support for Care Managers

July 11, 2025Garrett SchmittNo CommentsACOs, vbc, Webinar

 Download Slides Caring for individuals with intellectual and developmental disabilities (IDD) requires a unique approach. Join Dr. Craig Escudé—national expert in IDD health—and TCARE’s Jodi Fenner as they explore key concepts in effective care management. From understanding baseline health risks to recognizing the role of social and environmental factors, this session will offer foundational…

Trends in Market Share Among Hospitals Participating in ACOs and Nonparticipants

July 9, 2025Garrett SchmittNo Comments

Takeaway Points We assessed trends in market share over time among short-term acute care hospitals participating in accountable care organizations (ACOs) and non-ACO participants. ACO participation was associated with an increase in mean market share. ACO participation was associated with additional market share gains in more (vs less) concentrated markets. More importantly, baseline (2011) market…

CMMI Model Reports and Findings

July 8, 2025Garrett SchmittBPCI, BPCI Advanced

The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) has released and are highlighting evaluation reports and publications. You can access reports by going to the evaluations and research reports page of the Innovation Center website. Bundled Payments for Care Improvement Advanced Model Evaluation of Model Year 5 (2022) – Key Takeaways:…

One Big Beautiful Bill Act — What physicians need to know

July 7, 2025Garrett SchmittCMS, MA, MACRA, Medicare Advantage

On July 4, President Donald J. Trump signed into law the legislation and spending plan known as the One Big Beautiful Bill Act (OBBBA). The bill has a number of effects across different sectors of the economy, including health care. This slideshow compiles some facts, figures and responses from a variety of sources that analyzed…

From Fee-for-Service to Value-Based Care: Enhancing Outcomes in Nephrology

July 4, 2025Garrett SchmittFee for service, FFS

The traditional fee-for-service (FFS) healthcare model isn’t well-suited to meet the complex needs of patients with chronic illnesses including chronic kidney disease (CKD). As costs spiral and population health declines, value-based care (VBC) presents a solution that can reshape how the healthcare system approaches CKD management and can serve as a model for how we…

Transparency in Coverage Final Rule

July 2, 2025Garrett Schmitt

The healthcare industry’s landscape shifted dramatically with the implementation of the Transparency in Coverage (TiC) Final Rule. For compliance professionals navigating this regulatory terrain, understanding both the letter and spirit of these requirements has become essential – not just for avoiding penalties, but also for leveraging transparency as a strategic advantage. The Regulatory Foundation The…

A decade of value-based care: Tammy Schaeffer, JD, RN

June 30, 2025Garrett SchmittCMS, MA, MACRA, Medicare Advantage

A decade ago, the federal government launched its large-scale Medicare Access and CHIP Reauthorization Act (MACRA) in an attempt to move more physicians into value-based care to rein in exploding costs and improve care. In July, Medical Economics will release the second edition of Medical Economics Insider featuring an in-depth look at how successful MACRA has been and what…

RECORDED WEBINAR: CMS has announced increased audits: Preparing your Practice for the Inevitable

June 25, 2025Garrett SchmittNo CommentsACOs, Coding, compliance, vbc, Webinar

 Download Slides Are you prepared for heightened scrutiny from the Centers for Medicare & Medicaid Services (CMS)? CMS is dramatically amplifying its audit efforts, with a renewed focus on Medicare Advantage plans and Risk Adjustment Data Validation (RADV) audits. This is not just another day at the office—CMS is expanding its audit workforce, increasing…

RECORDED WEBINAR: Creating Your Risk Reimbursement Strategy in a Time of Scarcity

June 24, 2025Garrett Schmitt1 CommentACO reporting, ACOs, APP, APP measures, eCQM, vbc, Webinar

 Download Slides We are entering into a period of scarce health care resources, with less funding to support new developments but higher focus on cost control. Many reimbursement vehicles, both governmental and private health plans, will adopt risk-based reimbursement. How do providers manage the transition to risk payment models? Is it still prudent to…

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