The Ambulatory Specialty Model (ASM) represents a significant shift from the traditional MIPS reporting system, aiming to enhance the accountability of specialists regarding patient outcomes and costs. Unlike MIPS, which operates like a choose-your-own-adventure format, ASM introduces a more structured approach, emphasizing greater responsibility in managing patient care. This change is substantial and requires clear…

Trying to figure out how to pick between the Ambulatory Specialty Model (ASM) and other QPP options? With all the changes in Medicare reporting, it can feel like the rules shift every year. If you’re practicing in a specialty or just want to make sure you’re ready for what’s coming, understanding the differences is key….

February 26, 2026 – Long-term care is becoming a care concept rather than a care setting. It’s another node in the care ecosystem where medication intelligence is the connective tissue and a critical success factor for home-based care. If you mention long-term care (LTC), most people think of nursing homes – brick and mortar facilities where…

Submitting data to CMS is one of those tasks that sounds straightforward until you realize how many moving parts are involved. A missed measure, an incomplete record, or a data entry mistake can drag down your MIPS score and leave money on the table. The good news is that a solid internal audit can catch…

You cannot control CMS raising cut points. But you can control how you respond. Changes are happening to how Medicare Advantage plans are measured for medication adherence. Starting in measurement year 2026, CMS is introducing sociodemographic status (SDS) risk adjustment into the three Part D adherence measures: diabetes medications, RAS antagonists, and statins. What’s Actually…

The 2026 Medicare Physician Fee Schedule Final Rule is Here The 2026 Medicare Physician Fee Schedule (MPFS) Final Rule is out and you’re wondering what it means for you. It’s packed with finalized updates on MIPS, six new MVPs, easier ACO reporting, a new program model, and acknowledgment of the extensive feedback received on multiple…

You cannot control CMS raising cut points. But you can control how you respond. The 2026 requirements are clear. CMS is implementing risk-adjusted measures focused on Social Determinants of Health. The new Excellent Health Outcomes for All reward ties STAR ratings exclusively to performance among your hardest-to-engage members—Dual-Eligible, Low-Income Subsidy, and disabled populations. These changes…