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2025 DIY Guide to MSSP ACO eCQM Reporting: From Clinical Data Chaos to Submission Success

July 17, 2025Garrett SchmitteCQM

Is your Medicare Shared Savings Program (MSSP) ACO ready to tackle the complex world of electronic Clinical Quality Measures (eCQM) reporting? While some organizations consider building their own internal reporting capabilities, the reality is that aggregating data from multiple EHRs, ensuring measure compliance, and preparing submission-ready files requires significant expertise and coordination that many underestimate.  eCQM reporting for MSSP…

Making Value-Based Payment The Best Choice For Providers

July 16, 2025Garrett SchmittMA, Medicare Advantage

The Center for Medicare and Medicaid Innovation (CMMI) has announced a refreshed strategy to promote evidence-based prevention, empower beneficiaries to achieve their health goals, and promote competition and choice in health care markets. Value-based payment (VBP) can advance that vision, but only if CMMI dramatically amplifies the will among provider organizations to fully commit to generating health…

Value-based care’s blind spot: The missing link few are talking about

July 16, 2025Garrett SchmittMA, skilled nursing facilities, SNF, SNFs

What if a potent driver of value-based success isn’t found in your clinical programs but in the first few minutes your residents spend with your team? Long-term care is racing toward value-based care (VBC). You obsess over quality measures, satisfaction surveys and readmission rates. You invest in clinical pathways, technology and staff training. But when…

New Opportunities for Healthcare AI: Decoding the 2026 Medicare Advantage Rate Hike

July 16, 2025Garrett SchmittMA, Medicare Advantage

Last month, the Centers for Medicare & Medicaid Services (CMS) released its 2026 Medicare Advantage (MA) Rate Announcement, projecting a 5.06% average increase in payments to MA plans. That’s a notable jump from the 3.70% increase we saw in 2025. More than just a financial adjustment, this signals growing confidence in the Medicare Advantage model—and with…

CMS proposes rule aligning Medicare physician payment with ‘Big Beautiful Bill,’ MACRA

July 15, 2025Garrett SchmittCMS, MACRA

The Trump administration proposed a sweeping physician payment rule on Monday that rewrites Medicare payment to comply with recently passed GOP tax and policy law — and decade-old healthcare legislation. The CMS’ proposed physician fee schedule for 2026 includes a base rate hike of 2.5%. The increase was a handout to providers in the controversial “One…

The Case For Integrated ACOs For Dual-Eligible Beneficiaries

July 14, 2025Garrett SchmittMA, Medicare Advantage

Integrating care for people dually eligible for and enrolled in Medicare and Medicaid remains a bipartisan policy priority. Because Medicare and Medicaid are administered and funded separately, most dual-eligible beneficiaries receive coverage through two distinct programs with separate budgets, which lack financial incentives to coordinate care. To address these misaligned payment incentives, much of policy makers’ efforts…

How ASCs can reach their value-based care goals

July 14, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

The transition to value-based care may seem daunting for many healthcare leaders, especially those who operate independently and have less margin for error when it comes to implementing new systems and initiatives. Flagler Health is a technology company offering AI tools and other advanced technologies to streamline many aspects of patient care for medical practices….

RECORDED WEBINAR: Key Concepts in IDD Health Support for Care Managers

July 11, 2025Garrett SchmittNo CommentsACOs, vbc, Webinar

 Download Slides Caring for individuals with intellectual and developmental disabilities (IDD) requires a unique approach. Join Dr. Craig Escudé—national expert in IDD health—and TCARE’s Jodi Fenner as they explore key concepts in effective care management. From understanding baseline health risks to recognizing the role of social and environmental factors, this session will offer foundational…

Trends in Market Share Among Hospitals Participating in ACOs and Nonparticipants

July 9, 2025Garrett SchmittNo Comments

Takeaway Points We assessed trends in market share over time among short-term acute care hospitals participating in accountable care organizations (ACOs) and non-ACO participants. ACO participation was associated with an increase in mean market share. ACO participation was associated with additional market share gains in more (vs less) concentrated markets. More importantly, baseline (2011) market…

CMMI Model Reports and Findings

July 8, 2025Garrett SchmittBPCI, BPCI Advanced

The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) has released and are highlighting evaluation reports and publications. You can access reports by going to the evaluations and research reports page of the Innovation Center website. Bundled Payments for Care Improvement Advanced Model Evaluation of Model Year 5 (2022) – Key Takeaways:…

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