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Value-Based Care Gets Real

April 28, 2025Garrett Schmitt

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…

ACO REACH Falls Short In Serving Vulnerable Populations Compared To Medicare Overall

April 28, 2025Garrett Schmitt

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,…

The secrets to success with bundled payments in healthcare

April 28, 2025Garrett Schmitt

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…

ACO REACH Misses Target In Serving High-Risk Groups

April 25, 2025Garrett Schmitt

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…

ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz

April 23, 2025Garrett SchmittNo Commentsrecruitment

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…

AI and value-based care: a partnership to transform healthcare

April 21, 2025Garrett Schmitt

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…

RECORDED WEBINAR: Navigating Dementia Care: Comprehensive Support for Caregivers & Loved Ones Through the GUIDE Model

April 17, 2025Garrett SchmittNo CommentsACOs, vbc, Webinar

 Download Slides Join TCARE and Isaac Health for a webinar showcasing their partnership in the CMS GUIDE Model, which delivers comprehensive support for both individuals with dementia and their caregivers. Isaac Health provides expert-led dementia care, including personalized treatment plans, 24/7 telehealth access, and care coordination for patients. Meanwhile, TCARE supports caregivers with evidence-based…

AMGA, physician group announce national collaboration to improve value-based care

April 16, 2025Garrett Schmitt

A new partnership aims to strengthen accountable care models in health care practices around the country. AMGA, the American Medical Group Association, and Wilmington Health announced a partnership to start the AMGA Value Care Network. It is a new strategic initiative and collaboration to “deliver scalable solutions that empower AMGA member organizations to thrive in value-based care environments.” “We…

Generative AI can save healthcare, but not without payment reform

April 16, 2025Garrett Schmitt

Will the U.S. healthcare system achieve a technological breakthrough, or will another promising tool die on the vine due to medicine’s illogical financial model? That was the question I set out to answer this morning from the main stage of the 10th annual Accountable Care Symposium in Orlando, Florida—an event hosted by Wellvana, one of…

RECORDED WEBINAR: Winning in HEDIS/Stars: Proactive Strategies for Medicare Advantage Success

April 15, 2025Garrett SchmittNo CommentsACOs, vbc, Webinar

 Download Slides In today’s dynamic Medicare Advantage landscape, staying competitive requires innovative strategies and proactive engagement, driven by real-time data. Join us for an insightful webinar where we’ll explore cutting-edge approaches to HEDIS and quality management, informed by real-world experiences and powered by the latest technologies.This session will provide you with actionable strategies to…

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