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Your top questions on LEAD & MA changes — answered

April 20, 2026Garrett Schmitt

This FAQ is based on our March 25, 2026 webinar “Taking the LEAD on CMS Policy Updates for VBC Excellence” and has been updated to reflect policy finalization through April 8, 2026. Note:‍ The application process for LEAD is expected to be competitive – meeting eligibility criteria does not ensure acceptance. Current ACO REACH PY 2026 participants may…

Getting Buy-in From Nephrologists to Participate in Alternative Payment Models

April 17, 2026Garrett Schmitt

Evergreen Nephrology, which works with practices on value-based payment models for kidney care, operates across 24 states with a network of over 1,000 providers. Scott Lloyd, the company’s chief development & strategy officer, recently spoke with Healthcare Innovation about the importance of provider buy-in for value-based care. We were joined by Britt Newsome, M.D., M.P.H., chief medical…

Benchmarking: The Math That Will Decide Whether LEAD Works

April 16, 2026Garrett Schmitt

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,…

LEAD the Way: An 8-Minute Primer on Accountable Care’s Next Chapter

April 16, 2026Garrett Schmitt

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…

Generative AI in healthcare: Adoption matures as agentic AI emerges

April 16, 2026Garrett Schmitt

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,…

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…

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