Editor’s note: This is the third article in a series about CMS’ new LEAD model. Article one explored the new model in broad strokes. Article two discussed AI-Inferred Risk Adjustment. Future posts will explore CMS-administered risk arrangements and beneficiary enhancements. LEAD, CMS’ ten-year bet on accountable care, replaces ACO REACH, a model planned to sunset on December 31,…
In this episode, Gabriel Scott, Kevin Alonso, and Kennedy Caldwell break down the new Long Term Enhanced ACO Design (LEAD) Model and its impact on accountable care. They provide background on the model, outline key new features, and discuss five issues that Accountable Care Organizations and providers should consider as they evaluate participation. Listen to…
Over the past two years, healthcare leaders have shifted from questioning whether and where gen AI is relevant to focusing on how it can be used responsibly and at scale. Our latest survey of US healthcare leaders highlights several signals of gen AI’s maturation: Half of leaders report that their organizations have already implemented gen AI,…
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…
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…
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…
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…
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…
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…
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…