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MedCity FemFwd: Advancing Value-Based Care in Women’s Health

August 1, 2025Garrett Schmittwomen, women in medicine

In this episode, we’re joined by Dr. Keith Berkle, chair of Privia Women’s Health, who discusses the challenges OBGYNs face in transitioning to value-based care. Welcome back to another episode of MedCity FemFwd, a podcast dedicated to discussing the breakthroughs and challenges in women’s health. In this episode, we’re joined by Dr. Keith Berkle, chair…

RECORDED WEBINAR: From Data to Dignity: Using Predictive Analytics to Drive Proactive, Patient-Aligned Care

July 31, 2025Garrett SchmittNo CommentsACOs, hospice, palliative care, vbc, Webinar

 Download Slides This webinar will demonstrate how an ACO integrated AI-powered predictive models into its advanced care planning programs to identify patients earlier and improve alignment with their care goals. Participants will explore how these tools analyze complex patient data to forecast risk, support timely advanced care planning, and optimize resource allocation. Real-world case…

Fee-For-Service, Accountable Care Organizations, And Medicare Advantage: Why?

July 30, 2025Garrett SchmittFee for service, FFS, MA, Medicare Advantage

Abstract This Perspective discusses the fiscal challenge facing Medicare and how that challenge may be differentially met by fee-for-service, accountable care organization (ACO), and Medicare Advantage (MA) payment systems. The non-MA part of Medicare includes both fee-for-service and ACO payment systems and is sometimes referred to as traditional Medicare. Fee-for-service, although in need of reform,…

Facilitating Better Data Sharing and Interoperability Between Payers and Providers to Improve Care Coordination and Patient Outcomes

July 30, 2025Garrett Schmitt

The best decision will always be an informed decision – especially in healthcare. The more data that your providers have about you and your health, the better they can care for you. The only problem in this case is that you don’t receive all of your healthcare at the same location from the same doctor….

RECORDED WEBINAR: The $280 PMPM Problem: The Hidden Cost Drivers of Musculoskeletal Health (MSK) Conditions

July 29, 2025Garrett SchmittNo CommentsACO reporting, ACOs, APP, APP measures, eCQM, vbc, Webinar

 Download Slides Did you know that MSK conditions affect over 50% of adults and cost the health care system an estimated $420 billion annually— that’s more than diabetes, heart disease or any other chronic condition that plagues our population. And, in addition to the surgeries, PT, imaging and medication costs, you can add another $83B…

Shift to value-based care will stumble without help from Congress

July 28, 2025Garrett Schmitt

The AMA has joined dozens of other physician and health care associations and hundreds of accountable care organizations (ACOs), health systems, hospitals and physician practices in calling on Congress to take steps to sustain the nation’s transition to value-based care. Congress, the AMA and others said, should prioritize extension of Medicare’s advanced alternative payment model…

CMS is Demanding Change in Specialty Care: 5 Things to Know about ASM

July 24, 2025Garrett SchmittProposed Rule

Heads up! CMS’s Proposed 2026 PFS Rule introduces a new payment model for tackling specialty care and costs in traditional Medicare. Clearly not a snap decision, Ambulatory Specialty Model (ASM) has been cooked until well-seasoned and served up in 210 pages of the proposed Rule. Unlike a typical Notice from the CMS Innovation Center that initiates many Value-Based Care…

CMMI and the One Big Beautiful Bill Act are all in on prevention

July 24, 2025Garrett SchmittMA, Medicare Advantage

The national conversation around primary care — for both the private and public sectors — is experiencing a profound shift towards prioritizing value, prevention and outcomes over wasteful spending. This transformation comes at a critical time. Despite the shortage of providers the U.S. is now facing, investment in primary care saves money and leads to better outcomes by reducing the…

Evolving the CPT Code Set to Avail Value-Based Care

July 23, 2025Garrett SchmittProposed Rule

As the US healthcare system speeds up its pivot from volume to value, one crucial tool, which is often overlooked in mainstream discourse, is slowly but surely going through a necessary shift—the current procedure terminology, CPT code set. Developed as well as maintained by the American Medical Association (AMA), the CPT code set has long…

Specialty risk: The next frontier of value-based care

July 22, 2025Garrett Schmitt

Specialty care has emerged as a major driver of increasing US healthcare spending. Specialty care focuses on specific body systems or diseases, such as orthopedics or oncology. Primary care, by contrast, covers a range of health services addressing common illnesses and prevention. Payers and health systems are seeking ways to improve patient experiences and outcomes…

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