Health insurer Humana and independent primary care network Aledade are expanding their partnership, extending services to rural health clinics and federally qualified health centers (FQHCs) with an eye toward achieving and sustaining value-based care. The expanded collaboration will provide upfront resources, support and a timeframe for success for FQHCs and rural health clinics in 26…
Download Slides CMS’ new mandatory episode-based payment model, the Transforming Episode Accountability Model (TEAM), is scheduled to begin Jan. 1, 2026, affecting reimbursement for five high-volume surgical procedures. Data is key for hospitals to prepare for TEAM and to understand how markets will be impacted throughout the nation. Key takeaways: Join our Mandatory CMS…
Boston-based Community Care Cooperative (C3), an accountable care organization (ACO) founded and governed by Federally Qualified Health Centers has added four more FQHCs to its network participating in the Centers for Medicare & Medicaid Services Medicare Shared Savings Program (MSSP). C3 announced that it has partnered with two FQHCs in California, one in the District…
After more than a decade of experimentation, the verdict on value-based payment (VBP) models is decidedly mixed—there have been modest improvements in spending and quality but without breakthrough success in driving better health outcomes and sustainable spending at scale. Without dramatic changes in strategies, VBP risks becoming a footnote to the urgent challenges facing the…
The healthcare industry is undergoing significant changes, with the shift toward value-based care (VBC) taking center stage. As the sector moves away from fee-for-service models, rising costs and evolving administrative models pose new challenges. However, policy reforms and interoperability standards are creating opportunities to improve patient outcomes, reduce costs and streamline administrative processes. Although the…
Imagine a healthcare organization committed to improving patient outcomes while controlling costs. They have the right intentions, yet gaps in care coordination lead to preventable hospital readmissions, and they struggle to meet the quality benchmarks required for value-based care contracts. The challenge? Their data is fragmented across multiple systems, making it difficult to gain a…
Accountable care organizations (ACOs) still play an important role in value-based care, and shifting away from them at this time would be a mistake, according to Luke Hansen, M.D., M.H.S. In a video interview with Managed Healthcare Executive, Hansen explained why ACOs are still important. “Bundled programs are a necessary piece,” Hansen said. “The ACO…
Download Slides Exploring how AI-driven analytics can transform care management through focus on Population Health Risk Stratification and Predictive Modeling. We will discuss how advanced data science techniques using Electronic Health Records (EHR) and claims data provides us an opportunity to perform risk stratification to help identify high-risk populations, predict adverse health events, and…
The future of value-based care under the current Trump administration depends on a variety of factors, according to Luke Hansen, M.D., M.H.S., and chief medical officer of Arcadia. “Changes in administration are an opportunity to reexamine the success of previous programs,” Hansen said in a video interview with Managed Healthcare Executive. “My take on it…
Download Slides Cuts in the federal budget might be like running into a buzz saw for your health care finances. For academic systems, loss of indirect costs of research alone could wipe out 30% or more of the bottom line. Along with that, proposed changes in Medicaid, elimination of medical debt money, and redirection…