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Medicare quality measures were capped even as most eligible doctors never reported them

April 15, 2026Garrett Schmitt

New research from the Harvey L. Neiman Health Policy Institute found that most Merit-Based Incentive Payment System (MIPS) quality measures designated as “topped out” by the Centers for Medicare & Medicaid Services (CMS) were reported by only a small fraction of eligible physicians, suggesting these measures may not reflect consistently high performance across clinicians. Topped…

Making Cancer Support Services Sustainable in Value-Based Care

April 15, 2026Garrett SchmittNo Commentsrecruitment

Over the past decade, the oncology community has generated a tremendous amount of evidence on the multitude of benefits of embedding supportive health care delivery interventions within clinical workflows of oncology providers.1-5 Despite the undeniable improvements in cost, quality, and patient experience, these programs, including formalized lay navigation and psychosocial support as well as proactive…

RECORDED WEBINAR: A Readmission Breakthrough: How Structured Insights Improve Transitions of Care and Close the Discharge Gap

April 15, 2026Garrett SchmittNo Commentsvbc, Webinar

 Download Slides Reducing hospital readmissions remains a central goal of value‑based care, yet many effective solutions are difficult to scale due to cost or operational burden. ilumed and Connective Health have pioneered a different approach that reduced hospital readmissions in Q4 2025 from 16% to 11% (27.5% reduction). By rethinking post‑discharge workflows, this program…

RECORDED WEBINAR: Value-Based Surgical Care: How Predictive-Prevention Platforms Lower Readmissions, Improve Outcomes, and Increase Margins

April 14, 2026Garrett SchmittNo CommentsACOs, AI, vbc, Webinar

 Download Slides Surgical care is one of the most significant drivers of cost, outcomes, and financial performance in value-based healthcare. Yet many surgical complications, readmissions, and same-day cancellations are not random—they are predictable and preventable. In this webinar, we’ll explore how predictive-prevention platforms are transforming perioperative care by enabling hospitals to identify high-risk patients…

Fix operations, not contracts: How to make value-based care work

April 13, 2026Garrett Schmitt

In healthcare, value-based care has become a familiar goal – improving outcomes while using resources more responsibly. Yet as organizations shift from fee-for-service (FFS) reimbursement to value-based arrangements, a critical gap persists between intent and execution. Much of the focus remains on incentives and contract structures, while far less attention is paid to the operational foundation required…

AI-Inferred Risk Adjustment in LEAD: A Quiet but Consequential Shift

April 9, 2026Garrett Schmitt

Editor’s note: This is the second article in a series on CMS’ new LEAD model. Article one explored the new model in broad strokes. Future posts will explore CMS-administered risk arrangements and beneficiary enhancements. One of the least discussed elements of CMS’ new LEAD model may turn out to be one of the most consequential. CMS has…

RECORDED WEBINAR: Utilizing AI Employees to Free-Up Bandwidth for Practices

April 8, 2026Garrett SchmittNo CommentsACOs, vbc, Webinar

 Download Slides In this webinar, we discuss real examples of AI agents working across EHRs offloading routine admin work like risk adjustment and quality while surfacing only what clinicians need to see. Discover how leading groups are building AI-native operations that scale without added staffing or burnout. Speakers: Mark Pothen – CEO & Co-Founder of…

Can Price Controls Be Reconciled With Value-Based Care?

April 7, 2026Garrett Schmitt

As the healthcare affordability crisis escalates, efforts to fix the U.S. health system seem to have hit a wall. Some policy experts are calling for government price controls, while other experts and healthcare leaders still support value-based care (VBC), despite its limited impact on national health spending. Can these two schools of thought be reconciled…

What To Know About CMS’ 10-Year Bet on Accountable Care with LEAD

April 2, 2026Garrett Schmitt

On March 31st, 2026, CMS released details on a new model called LEAD — the Long-term Enhanced ACO Design. It’s positioned as a replacement for ACO REACH. However, LEAD is not just an evolution of ACO REACH. It’s a fundamentally different proposition: a ten-year model with a fixed benchmark that never rebases, an integrated approach to…

An effective value-based care model shouldn’t cost $75,000 extra per year, says Marta J. Van Beek, M.D., M.P.H.

April 2, 2026Garrett Schmitt

Dermatology is moving toward outcome-based measurement, but the systems to capture patient outcomes (especially through EHRs or mobile tools) are still difficult and costly to implement, according to Marta J. Van Beek, M.D., M.P.H., a dermatologic surgeon at University of Iowa Health Care and a clinical professor at the university’s Carver College of Medicine. She…

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