Many health systems struggle to achieve cost savings in value-based care due to care management gaps and fragmented care delivery, particularly for patients with complex needs. To address these silos, health systems must adopt proactive, continuous care management with standardized communications and leadership support across all organizational levels. This can be accomplished by mapping care…
Accountable care can be a useful tool for providing safety-net providers with more sustainable and flexible financing for meeting their patients’ needs. However, most safety-net organizations face multiple existing barriers to advancing accountable care in the safety net. Further, accountable care is at an inflection point, and several health policy proposals may affect accountable care….
This week, our In Focus section focuses on a March 12, 2025, announcement from the Centers for Medicare & Medicaid Services (CMS) regarding CMS Innovation Center programs under the new Administration. After reviewing the Innovation Center’s model portfolio, CMS has elected to discontinue four models ahead of their original end dates: Maryland Total Cost of Care (TCOC), Primary Care First (PCF), End-Stage Renal Disease…
Download Slides Caregiving has changed dramatically over the past five years. More caregivers are juggling full-time jobs, relationships are shifting beyond immediate family, and stress levels are rising. Thankfully, there are tools and strategies to lighten the load and prevent burnout. Join TCARE’s experts as we explore key demographic shifts, emerging trends, and what…
How should health systems and insurers talk to policymakers, patients and plan members about the concept of value-based care? That was one of the questions addressed by a recent panel discussion hosted by the Duke Margolis Institute of Health Policy. Kevin Larsen, M.D., senior vice president of clinical innovation at Optum, and a former senior…
Boston-based Community Care Cooperative (C3), an accountable care organization (ACO) founded and governed by Federally Qualified Health Centers has added four more FQHCs to its network participating in the Centers for Medicare & Medicaid Services Medicare Shared Savings Program (MSSP). C3 announced that it has partnered with two FQHCs in California, one in the District…
For organizations hoping to draw out savings from value-based care, added administrative burdens might be a source of hesitation. However, some operators are successfully turning to technology offerings that maximize reimbursement, pinpoint essential data, and include platforms already used by referral partners and managed care organizations (MAOs). AI programs can help “tease out” some of…
Navina, an AI-enabled clinical intelligence platform for primary care providers, announced the close of a $55 million Series C funding round, bringing its total raise to $100 million. Growth Equity at Goldman Sachs Alternatives led the round, with participation from existing investors Vertex Ventures Israel, ALIVE and Grove Ventures. WHAT IT DOES Navina offers providers,…
Health insurer Humana and independent primary care network Aledade are expanding their partnership, extending services to rural health clinics and federally qualified health centers (FQHCs) with an eye toward achieving and sustaining value-based care. The expanded collaboration will provide upfront resources, support and a timeframe for success for FQHCs and rural health clinics in 26…
Download Slides CMS’ new mandatory episode-based payment model, the Transforming Episode Accountability Model (TEAM), is scheduled to begin Jan. 1, 2026, affecting reimbursement for five high-volume surgical procedures. Data is key for hospitals to prepare for TEAM and to understand how markets will be impacted throughout the nation. Key takeaways: Join our Mandatory CMS…