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Multi-Payer VBC Strategy Is Essential for Cost Control, but Providers Must Get a Fair Deal

June 6, 2025Garrett Schmitt

To meet its goals of controlling costs and improving patient care, Value-Based Care requires a near-universal, multi-payer strategy. Only when payment incentives induce cost-effective health care for all patients, as well as provider accountability and patient engagement, will we get that result. Incremental adoption of value-based payments is instructive, but this approach lacks impact when…

FLASH INTERVIEW – Symbion Coding Inc – 2025

June 4, 2025Garrett SchmittNo Comments

 Symbion Coding partners with medical organizations to develop tailored solutions they need to enhance their operations, improve compliance, and achieve accurate financial results. Founded in 2015, Symbion Coding has worked with several clients to optimize their coding and billing compliance, improve their coding accuracy, and unlock millions of dollars in revenue. Symbion Coding understands the…

A decade of value-based care: Mark McClellan, MD

June 4, 2025Garrett Schmitt

A decade ago, the federal government launched its large-scale Medicare Access and CHIP Reauthorization Act (MACRA) in an attempt to move more physicians into value-based care to rein in exploding costs and improve care. Later this summer, Medical Economics will release the second edition of Medical Economics Insider featuring an in-depth look at how successful MACRA has been and…

Is ‘value-based care’ ill-defined?

June 4, 2025Garrett SchmittMA, skilled nursing facilities, SNF, SNFs

“Value-based care” (VBC) is one of the most frequently cited goals in U.S. healthcare reform — yet its meaning remains frustratingly vague and often contradictory. We hear that value-based care is the future. But as we navigate payment reforms, new quality programs, and evolving care models, we’re forced to ask: Whose definition of “value” are we…

Transforming Healthcare: Implementing and Advancing eCQMs

June 2, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

Electronic Clinical Quality Measures (eCQMs) are revolutionizing the way healthcare organizations evaluate care quality, track patient outcomes, and meet regulatory requirements. By embracing digital solutions, providers can not only streamline reporting processes but also deliver higher-quality care tailored to individual needs. This blog combines practical steps for eCQM implementation with the latest trends shaping their…

How Community Health Centers Can Partner with Organizations to Adopt Value-Based Care

May 30, 2025Garrett Schmitt

Value-based payment (VBP) — which ties health care reimbursement to quality and cost outcomes — has gained traction across the health care sector. Primary care providers participating in VBP arrangements have often performed well, likely due to their focus on prevention and cost-efficient care. However, community health centers (CHCs), which provide primary care to more than…

How Behavioral Health Providers Can Build Better Value-Based Care Infrastructure

May 30, 2025Garrett Schmitt

There is an eagerness across the behavioral health industry to transition from fee-for-service into value-based contracts. But, at times, this urgency can actually be a hindrance instead of a help, industry insiders recently explained at the Behavioral Health Business VALUE conference. Crafting value-based care infrastructure, understanding how and what to measure and defining the mechanisms…

The Pharmacist Role in Value-Based Care and on Multidisciplinary Teams: Eileen Peng, PharmD

May 30, 2025Garrett Schmitt1 Commentrecruitment

In value-based care models, pharmacists play an important role in multidisciplinary team care in selecting cost-effective treatments and managing adherence to prevent hospitalizations and emergency department (ED) visits, explained Eileen Peng, PharmD, vice president, chief administrator, and pharmacy officer, Astera Cancer Care. Full Article

BHB VALUE: Winning with Simplicity — How a Unified Tech Stack Prepares You for Value-Based Care

May 30, 2025Garrett Schmitt

Behavioral Health Business: I’m going to introduce our panelists here. I’ve got Michael Frisby, the Chief Growth Officer at Sandstone Care; Melissa McCarthy, Co-founder and Managing Partner at The Reprieve; and Lindsay Beasley, Director of Solutions Engineering at Sunwave. I’m going to sit down and enjoy the conversation with you all. Take it away. Michael Frisby: Great….

Is CMS going to wreck ACOs with bad math?

May 29, 2025Garrett Schmitt

Aledade and other accountable care organizations are pressing the Centers for Medicare & Medicaid Services to correct what they say is a major misstep in a financial benchmark model that could significantly reduce their earnings and possibly force some practices out of value-based care and discourage others from joining. The controversy centers on CMS’s Accountable…

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