Rewards tied to improved hospital readmission rates were so small and so variable from year to year that they likely contributed to a “lack of effectiveness” for a key nursing home financial incentive program. The Skilled Nursing Facility Value-Based Purchasing program is the Centers for Medicare & Medicaid Services’ largest use of financial incentives to…
This report provides a definitive analysis for venture capital (VC) investment in the value-based care (VBC) healthtech sector. While VBC represents a profound and necessary paradigm shift with a multi-trillion-dollar market opportunity, it is not an environment for unsophisticated capital. The core finding is a qualified “yes”: venture capital should strategically back VBC healthtech, but…
Download Slides The TEAM payment model is a CMS program that holds acute care hospitals accountable for surgical care and costs in five different types of surgery accounting for the highest costs in Medicare: CABG, Lower Extremity Joint Replacements, Femur Hip Fracture Repair, Spinal Fusion, and Major Bowel surgery. Central to the payment model…
It takes a village. Moving toward value-based care (VBC) in the U.S. healthcare system requires engagement and cooperation from multiple players. Stakeholders include accountable care organizations, social service and community-based organizations, multiple payers, and a range of providers. Ideally, these groups and individuals work seamlessly together to create multiple policies and payment strategies inherent to VBC…
This is part of our continuing coverage of the 2025 Oliver Wyman Health Innovation Summit. We previously wrote about how the industry can restore trust, and how leaders can reshape policy, payment models, and care delivery. During the final day of the 2025 Health Innovation Summit, Thomas Osborne, M.D., shared an all-too-familiar story about the fragility of…
Download Slides Join CoventBridge for an insightful session focused on strengthening your organization’s financial and regulatory health. Participants will walk away with practical strategies for developing and implementing effective monitoring, auditing, and reporting processes that support revenue integrity and proactively address fraud, waste, and abuse (FWA). This session will also explore how to leverage…
On Jan. 1, CMS will begin implementation of a new alternative payment system for select hospitals. The Transforming Episode Accountability Model will hold participating hospitals responsible for the care quality, costs and post-acute coordination associated with five surgical procedures. The model is intended to mark a shift toward shared accountability and a test of whether healthcare providers…
The shift towards value-based care in senior living is continuing in 2025, driven by rising resident acuity, tight margins and payer expectations. As acuity drives changes in how operators manage their communities, senior living providers are more closely tracking health outcomes to show the benefit of the services they provide to keep people from moving “downstream” in…
As value-based care (VBC) continues to redefine reimbursement models and quality standards in skilled nursing facilities (SNFs), the Director of Nursing (DON) plays a central role — driving clinical excellence, operational efficiency and financial performance. With hospitals, health plans and VBC programs increasingly viewing SNFs as strategic partners, the DON’s influence is just as vital…
Download Slides Special Feature: Download Summary Article AI spending in healthcare and life sciences is projected to grow from $11.6 billion in 2024 to $19 billion by 2027, with a five-year CAGR of 16.6%, per Gartner. However, a majority of these investments have focused on Gen AI / LLMs which have delivered limited value…