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…
Download Slides Discover how AI-powered retinal screening is transforming diabetic eye care and improving value-based quality scores. In this session, learn how an Accountable Care Organization (ACO) committed to value-based care, leveraged AI-driven solutions to enhance diabetic retinopathy (DR) screening in primary care settings. Hear firsthand insights from experts on the real-world implementation, workflow…
Download Slides Join us for a one-hour webinar on Tuesday, April 29, featuring Kayla Power, RN, BSN, ElaraConnect Director of Patient Care Coordination at Elara Caring, as she explores how Elara Caring is improving patient visibility for their home health agencies. You’ll also hear how Elara Caring accessed an expanded provider network to…
Question Did spending for patients attributed to accountable care organizations (ACOs) differ from other patients enrolled in Medicare in the first decade of the Medicare Shared Savings Program (MSSP)? Findings In this difference-in-differences study of more than 8 million patients, ACO formation was associated with a mean differential reduction of $142 (1.2%) in annual per-patient spending over…
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…
First catheters, now skin substitutes—and more areas of anomalous medical billing will continue to pop up, requiring data vigilance and collaboration on the part of accountable care organizations (ACOs), according to speakers at the National Association of ACOs (NAACOS) Spring 2025 Conference. The identification of these areas potentially signaling fraud aligns with the Trump administration’s…
Artificial intelligence (AI) and value-based care (VBC) are both regarded as transformative forces within healthcare. They have the potential to supercharge precision medicine, curb skyrocketing healthcare costs, and deliver the experience and outcomes from healthcare that patients truly want. But beyond their shared promise, they also share the common issue of struggling to gain real…