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The ‘price’ of value-based care

May 14, 2025Garrett SchmittMA, skilled nursing facilities, SNF, SNFs

The term “value-based care” is tossed around like a political football among healthcare policy makers. Nowhere is the meaning of this so variable as in nursing homes. The Nursing Home Value-Based Purchasing Demonstration project, completed over a decade ago, was not found to lower spending or improve quality. Webster’s Dictionary defines value as “the monetary worth of something,”…

The Evolving Physician Advisor: From UM to Value-Based Care & AI

May 13, 2025Garrett Schmitt

In today’s complex healthcare landscape, Physician Advisors (PAs) play an increasingly vital role in ensuring hospitals and health systems function smoothly, efficiently, and with a focus on patient-centered care. As healthcare spending continues to rise, the need for professionals who can effectively navigate the intersection of clinical practice and financial stewardship has never been greater. What is a Physician Advisor? Physician Advisors serve as…

CMMI Announces Make America Healthy Again Strategy, Prioritizes Choice For Care Settings, Including In Homes

May 13, 2025Garrett Schmitt

The Center for Medicare and Medicaid Innovation (CMMI) announced its approach to President Donald Trump and Secretary Robert F. Kennedy’s call to “Make America Healthy Again” – and it promises to, among other aims, increase patients’ ability to receive care in the setting of their choice, including the home. The new strategy, announced Tuesday, also…

RECORDED WEBINAR: Best Value-Based Care Strategies PT 2: Controlling Specialty Patient Care Costs and Total Costs for Negotiating Leverage

May 13, 2025Garrett SchmittNo CommentsACO reporting, ACOs, APP, APP measures, eCQM, vbc, Webinar

 Download Slides Best Value-Based Care Strategies for A Cost-Focused Future Provider strategies for Value-Based Care participation will be significantly different under the new federal administration’s cost cutting agenda. Along with changes in Medicare Advantage’s position in the new CMS vision of Value-Based Care, there are fewer payment models and hints of other changes to come….

A More Holistic Approach To Measurement For Value-Based Care

May 8, 2025Garrett Schmitt

Through pay-for-reporting and pay-for-performance programs, payers such as the Centers for Medicare and Medicaid Services (CMS) rely on quality measures to incentivize and make inferences about care quality and evaluate the performance of health care delivery innovations. The growth of pay-for-performance and value-based care (VBC) programs in the United States drives demand for quality measures…

Understanding the Fundamentals of Accountable Care Organizations

May 8, 2025Garrett Schmitt

The healthcare payment process is undergoing a dramatic transformation as payers and providers shift from volume to value. While stakeholders are currently piloting many value-based care models, accountable care organizations are among the most popular and successful models to date due to their emphasis on coordinated healthcare. These organizations not only facilitate seamless coordinated healthcare…

Jefferson Health’s strategy to optimize value-based care

May 7, 2025Garrett SchmittCCM, Chronic Care, HCC

Philadelphia-based Jefferson Health — now a 32-hospital system after the 2024 acquisition of Lehigh Valley Health Network — is prioritizing integration and financial sustainability post-transaction. Joseph Cacchione, MD, who has been CEO for the last two and a half years, said the health system — which also includes a nearly 400,000-member health plan and a…

Value-based payment, oncology and primary care — how can it all work together?

May 7, 2025Garrett Schmitt

A value-based payment model can drive collaboration between primary care physicians and oncologists to provide the best possible care for patients, said a former leader at the U.S. Centers for Medicare & Medicaid Services. Elizabeth Fowler, JD, PhD, was a keynote speaker on May 6 at the 2025 NCCN Policy Summit: Primary Care and Oncology Collaboration…

RECORDED WEBINAR: Conquering Readmissions: Proven Strategies and the Power of Digital Health in Value-Based Models

May 7, 2025Garrett SchmittNo CommentsACO reporting, ACOs, APP, APP measures, eCQM, vbc, Webinar

 Download Slides Hospital readmissions represent a significant challenge and cost burden for Value-Based Care Organizations. This webinar will delve into practical and effective strategies specifically designed to minimize avoidable readmissions. We will emphasize the crucial role of proactive transition of care, the strategic integration of virtual care technologies, and robust patient engagement strategies in…

RECORDED WEBINAR: Best Value-Based Care Strategies PT 1: Strategically Managing Your VBC Program w/ MA/ACO & Changes in Payment Models

May 6, 2025Garrett SchmittNo CommentsACO reporting, ACOs, APP, APP measures, eCQM, vbc, Webinar

 Download Slides Best Value-Based Care Strategies for A Cost-Focused Future Provider strategies for Value-Based Care participation will be significantly different under the new federal administration’s cost cutting agenda. Along with changes in Medicare Advantage’s position in the new CMS vision of Value-Based Care, there are fewer payment models and hints of other changes to come….

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