From primary care to hospital systems, many sectors have embraced the transition to value-based care (VBC), showing improvements in health care costs, patient satisfaction and outcomes. Yet one critical segment has been slower to adapt: in-home care. Despite playing an increasingly central role in care delivery – particularly for aging populations and individuals managing chronic…
CMS has clarified that only select Medicare claims will be held amid the ongoing federal government shutdown, walking back an earlier notice that suggested a broader payment pause. “In light of the continuing government shutdown, CMS will continue to process and pay held claims in a timely manner with the exception of select claims for…
Download Slides This engaging session we will discuss known areas of error, fraud, waste, and abuse in value-based care. Recent regulatory scrutiny Bad practices that lead to overpayment Examples in data mining, chart review, and leading queries SPEAKERS: – Amanda Brown – VP of Revenue Integrity– Colleen Gianatasio – VP of Compliance – Ray Evans…
Dive Insight: Healthcare organizations are looking at AI tools that could boost profit margins as providers and payers navigate an increasingly challenging financial landscape, according to the Klas and Bain report, which surveyed nearly 230 industry executives. Many providers still face workforce challenges that worsened during the COVID-19 pandemic, while bracing for a heightened number of uninsured patients due to Medicaid…
Complex patient populations require thoughtful and comprehensive health care, especially when it’s being delivered by accountable care organizations (ACOs) working within a complex array of reimbursement and delivery regulations. During a session of the National Association of ACOs (NAACOS) Fall 2025 Conference, speakers shared their strategies, suggestions, and policy wish lists for caring for these special populations…
Download Slides What is person-centered support? It’s not always what we think it is. Learn how to apply core person-centered thinking tools in your daily work to build stronger relationships, support informed decision-making, and create service plans that reflect what truly matters to the person. Featured Speakers: Jodi Fenner – VP of Execution and…
More than a decade after accountable care organizations launched, healthcare systems are still eager to bring more skilled nursing operators into the fold, according to several acute-care speakers at the National Association of ACOs Fall Conference being held in Washington, DC, this week. Financial incentives for nursing homes to sign on to ACOs not led…
Significant differences in maternal health outcomes were found in the Massachusetts Medicaid accountable care organization (ACO) program based on the ACO’s organizational structure, according to a recent investigation published in JAMA Network Open.1 The study analyzed 2 distinct models implemented by the state in 2018: model A, a partnership between a health system and a managed…
WASHINGTON, October 8, 2025 (Newswire.com) – The healthcare industry’s transition toward value-based care continues to accelerate, driven by analytics, automation, and interoperability platforms purpose-built for accountable care delivery. The national survey conducted by Black Book Research identified the top-rated software, managed service, and consulting firms supporting Accountable Care Organizations (ACOs), provider networks, and risk-bearing entities. The…
Accountable care organizations (ACOs) were created to improve quality and reduce unnecessary costs in Medicare by aligning providers’ financial incentives with patient outcomes. A central part of that mission is helping the federal government identify and reduce waste, fraud, and abuse. Unlike traditional fee-for-service Medicare, ACOs are rewarded for delivering high-value care, which gives them…