Senior living operators with value-based offerings are getting a boost from a nearly doubled Medicare Advantage (MA) capitation rate in 2026. The Centers for Medicare & Medicaid Services (CMS) previously announced a 5.06% increase in MA capitation rates, higher than what some analysts expected, including Macquarie Senior Healthcare Equities Research Analyst Tao Qiu. A capitation rate is a fixed…

Adoption of value-based care (VBC) programs has continued to expand. For example, the share of healthcare payments from risk-bearing VBC programs where providers could lose revenue if they did not meet quality or cost goals reached 28.5% in 2023, up from 12.5% in 2019. Despite this steady growth, the Centers for Medicare and Medicaid Services (CMS) will…

The Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) program is designed to provide value-based care access, including home-based care, to underserved communities. New research shows that in its inaugural year, the program fell short of its aims. REACH beneficiaries have lower levels of social risk compared to the overall Medicare population,…

CMS is gearing up for the first mandatory bundled payment program in 2026 – is your organization ready for a bundled payment future? As the U.S. healthcare system continues its shift away from fee-for-service (FFS) toward value-based care (VBC), the prevalence of advanced alternative payment models is increasing. Bundled payments are attracting significant attention as…

In its first year, Medicare’s Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model fell short of enrolling providers that serve patients with high social risks, according to a new study published in JAMA Health Forum. Researchers of the study said that without further participation from these types of organizations, the program is…