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How CMS’ Recent Capitation Rate Increase Could Accelerate Value-Based Care, MA in Senior Living

May 5, 2025Garrett Schmitt

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…

RECORDED WEBINAR: Impact of diabetic retinopathy screening program in a multi-site primary care practice – Healthcare from the Eye™

April 30, 2025Garrett SchmittNo CommentsACOs, vbc, Webinar

 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…

RECORDED WEBINAR: Elara Caring’s innovative approach to improving patient care coordination

April 29, 2025Garrett SchmittNo Commentsvbc, Webinar

 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…

Long-Term Spending of Accountable Care Organizations in the Medicare Shared Savings Program

April 28, 2025Garrett SchmittCCM, Chronic Care, HCC

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…

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…

Q&A with iRhythm Technologies: The importance of arrhythmia detection

April 24, 2025Garrett SchmittNo Commentshealthcare, heart disease, SPAC

Cardiovascular disease claims more lives than any other health condition in the U.S., with one person dying from it every 33 seconds.1 Arrhythmias, which are disruptions in the heart’s normal rhythm, represent a prevalent, yet often overlooked, aspect of cardiovascular health. These disruptions in the heart’s electrical system can cause palpitations, dizziness, fainting, or can even…

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…

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