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…
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…
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…
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…
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…
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….
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…