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RECORDED WEBINAR: The $280 PMPM Problem: The Hidden Cost Drivers of Musculoskeletal Health (MSK) Conditions

July 29, 2025Garrett SchmittNo CommentsACO reporting, ACOs, APP, APP measures, eCQM, vbc, Webinar

 Download Slides Did you know that MSK conditions affect over 50% of adults and cost the health care system an estimated $420 billion annually— that’s more than diabetes, heart disease or any other chronic condition that plagues our population. And, in addition to the surgeries, PT, imaging and medication costs, you can add another $83B…

Shift to value-based care will stumble without help from Congress

July 28, 2025Garrett Schmitt

The AMA has joined dozens of other physician and health care associations and hundreds of accountable care organizations (ACOs), health systems, hospitals and physician practices in calling on Congress to take steps to sustain the nation’s transition to value-based care. Congress, the AMA and others said, should prioritize extension of Medicare’s advanced alternative payment model…

CMS is Demanding Change in Specialty Care: 5 Things to Know about ASM

July 24, 2025Garrett SchmittProposed Rule

Heads up! CMS’s Proposed 2026 PFS Rule introduces a new payment model for tackling specialty care and costs in traditional Medicare. Clearly not a snap decision, Ambulatory Specialty Model (ASM) has been cooked until well-seasoned and served up in 210 pages of the proposed Rule. Unlike a typical Notice from the CMS Innovation Center that initiates many Value-Based Care…

CMMI and the One Big Beautiful Bill Act are all in on prevention

July 24, 2025Garrett SchmittMA, Medicare Advantage

The national conversation around primary care — for both the private and public sectors — is experiencing a profound shift towards prioritizing value, prevention and outcomes over wasteful spending. This transformation comes at a critical time. Despite the shortage of providers the U.S. is now facing, investment in primary care saves money and leads to better outcomes by reducing the…

Evolving the CPT Code Set to Avail Value-Based Care

July 23, 2025Garrett SchmittProposed Rule

As the US healthcare system speeds up its pivot from volume to value, one crucial tool, which is often overlooked in mainstream discourse, is slowly but surely going through a necessary shift—the current procedure terminology, CPT code set. Developed as well as maintained by the American Medical Association (AMA), the CPT code set has long…

Specialty risk: The next frontier of value-based care

July 22, 2025Garrett Schmitt

Specialty care has emerged as a major driver of increasing US healthcare spending. Specialty care focuses on specific body systems or diseases, such as orthopedics or oncology. Primary care, by contrast, covers a range of health services addressing common illnesses and prevention. Payers and health systems are seeking ways to improve patient experiences and outcomes…

RECORDED WEBINAR: Member/Patient Engagement that Moves the Needle: Strategies that Scale 

July 22, 2025Garrett SchmittNo CommentsACO reporting, ACOs, APP, APP measures, eCQM, vbc, Webinar

 Download Slides Initial and ongoing engagement is one of the toughest challenges in value-based care. Is your outreach too little—or too much? This webinar explores how to strike the right balance using multi-pronged strategies that drive outcomes without overwhelming patients. Learn how to stay nimble, personalize engagement, and avoid fatigue. Visit the Avery Telehealth…

CMS Commits to Control Total Cost of Care: 6 Volleys in the 2026 CMS PFS Proposed Rule

July 18, 2025Garrett SchmittProposed Rule

Summer is here, and the heat is on: barbeques, beaches, and the 2026 CMS Physician Fee Schedule Proposed Rule. Throughout 1,803 pages, CMS is going after the total cost of care in the MIPS and APM tracks of the Quality Payment Program (QPP). These proposed updates and the creation of a surprise new (and mandatory!) Alternate Payment…

2025 DIY Guide to MSSP ACO eCQM Reporting: From Clinical Data Chaos to Submission Success

July 17, 2025Garrett SchmitteCQM

Is your Medicare Shared Savings Program (MSSP) ACO ready to tackle the complex world of electronic Clinical Quality Measures (eCQM) reporting? While some organizations consider building their own internal reporting capabilities, the reality is that aggregating data from multiple EHRs, ensuring measure compliance, and preparing submission-ready files requires significant expertise and coordination that many underestimate.  eCQM reporting for MSSP…

Making Value-Based Payment The Best Choice For Providers

July 16, 2025Garrett SchmittMA, Medicare Advantage

The Center for Medicare and Medicaid Innovation (CMMI) has announced a refreshed strategy to promote evidence-based prevention, empower beneficiaries to achieve their health goals, and promote competition and choice in health care markets. Value-based payment (VBP) can advance that vision, but only if CMMI dramatically amplifies the will among provider organizations to fully commit to generating health…

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