Trying to figure out how to pick between the Ambulatory Specialty Model (ASM) and other QPP options? With all the changes in Medicare reporting, it can feel like the rules shift every year. If you’re practicing in a specialty or just want to make sure you’re ready for what’s coming, understanding the differences is key….
For the 114th episode of the CIO podcast hosted by Healthcare IT Today, we are joined by Mike Camacho, CEO at Sound Long Term Care, to talk about ACOs and long-term care! We kick this episode off by discussing why ACOs have been a challenge for long-term care. Then, Camacho shares what his experience and results…
A growing emphasis to meet patients where they’re at has led health systems and hospitals to take primary care out of its traditional setting. “We can’t expect people to alter their lives to fit into our schedule. We need to alter our schedule to fit into their lives,” MetroHealth President and CEO Christine Alexander-Rager, MD,…
The Center for Medicare and Medicaid Innovation (CMMI) has come under increased political scrutiny for its demonstration programs’ frequent failure to produce savings for Medicare and Medicaid. These failures are surprising given that many demonstration projects are designed around care interventions that have evidence of achieving savings and reducing avoidable health care use. It’s important…
Download Slides In this session, David Klebonis, President and COO-Palm Beach ACO, shares how they approached that problem: what broke down at scale, what they tried, and what changed when they moved from manual workflows to AI-driven execution. Zynix AI co-founder and MD Jay Chowdappa walks through the platform infrastructure behind those results and what it takes…
We’re spending billions trying to reduce length of stay. So why isn’t it improving? A small fraction of patients—just 2% of admissions—account for 15% of prolonged hospital days, costing more than $2 billion annually, or $2,093 per excess day, according to the Vizient Clinical Data Base. At the same time, hospital occupancy is projected to exceed the 85%…
Download Slides AI and digital health tools are rapidly expanding across healthcare, but many organizations still struggle to use them in a way that improves care without losing the human connection. Leaders from Qubika, an AI and data infrastructure firm specializing in healthcare, and Avery Telehealth, a leading population health digital platform, will focus…
V28 is no longer a transition issue. It is the live operating environment for Medicare Advantage risk adjustment in 2026. CMS completed the three-year phase-in of the 2024 CMS-HCC model for CY 2026, meaning plans and providers are now operating under the full model rather than a blended version. That makes mid-year the right moment…
The accountable care organization (ACO) model is shaping up to be the base that future value-based care models will be built on, with more than 50% of Medicare fee-for-service (FFS) beneficiaries being aligned with an ACO now. While there’s a lot of room for improvement in the ACO model, the Centers for Medicare and Medicaid…
In many accountable care organizations (ACOs), frontline physicians are under strong pressure to schedule Medicare annual wellness visits (AWVs) for every eligible patient. On paper, AWVs are framed as a cornerstone of value‑based care. In reality, for patients who already receive regular, well‑designed chronic care and follow‑up visits, a separate AWV can easily become cost‑ineffective. It adds encounters and expense without…