Health system ACOs rethink ‘value’ for big wins

August 26, 2025Garrett SchmittCCM, Chronic Care, HCC

Care New England Health System in Providence, R.I., has participated in value-based contracting for years with some success. But over the last 12 to 18 months, the health system has reframed how they think about “value” to serve the community better. “The Rhode Island landscape for value-based contracting has been financially challenging, and those pressures…

How ASCs can reach their value-based care goals

July 14, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

The transition to value-based care may seem daunting for many healthcare leaders, especially those who operate independently and have less margin for error when it comes to implementing new systems and initiatives. Flagler Health is a technology company offering AI tools and other advanced technologies to streamline many aspects of patient care for medical practices….

3 quality measures leaders are eyeing for the 2nd half of 2025

June 18, 2025Garrett SchmittCCM, Chronic Care, HCC

As the second half of 2025 approaches, hospitals and health systems are taking stock of their annual quality improvement initiatives and pushing forward. Three healthcare leaders shared with Becker’s the quality metrics they are tracking most closely, including efficient discharges and fall prevention. Question: Looking ahead to the second half of the year, what is one specific quality…

Albany Med, Honest Health partner on value-based care

June 11, 2025Garrett SchmittCCM, Chronic Care, HCC

Albany Med Health System, a nonprofit health system serving northeastern New York and western New England, has entered a strategic partnership with Honest Health to advance its value-based care capabilities. The collaboration, announced in April, will equip Albany, N.Y.-based Albany Med’s advanced practice providers, nurses and more than 800 physicians with real-time insights, predictive analytics and population…

Transforming Healthcare: Implementing and Advancing eCQMs

June 2, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

Electronic Clinical Quality Measures (eCQMs) are revolutionizing the way healthcare organizations evaluate care quality, track patient outcomes, and meet regulatory requirements. By embracing digital solutions, providers can not only streamline reporting processes but also deliver higher-quality care tailored to individual needs. This blog combines practical steps for eCQM implementation with the latest trends shaping their…

Jefferson Health’s strategy to optimize value-based care

May 7, 2025Garrett SchmittCCM, Chronic Care, HCC

Philadelphia-based Jefferson Health — now a 32-hospital system after the 2024 acquisition of Lehigh Valley Health Network — is prioritizing integration and financial sustainability post-transaction. Joseph Cacchione, MD, who has been CEO for the last two and a half years, said the health system — which also includes a nearly 400,000-member health plan and a…

Long-Term Spending of Accountable Care Organizations in the Medicare Shared Savings Program

April 28, 2025Garrett SchmittCCM, Chronic Care, HCC

Question  Did spending for patients attributed to accountable care organizations (ACOs) differ from other patients enrolled in Medicare in the first decade of the Medicare Shared Savings Program (MSSP)? Findings  In this difference-in-differences study of more than 8 million patients, ACO formation was associated with a mean differential reduction of $142 (1.2%) in annual per-patient spending over…

ASCs poised to win big in the value-based care revolution

February 26, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

As the healthcare industry continues its shift toward value-based payment models, ASCs could be poised to be major beneficiaries of this transformation. Many industry leaders believe ASCs’ cost efficiency, streamlined operations and focus on quality outcomes make them ideal candidates for success in a value-driven healthcare landscape. According to FTI Consulting’s “Hospital Operations Outlook Survey,”…

Coding Compliance: Mitigating Risk In Medicare Risk Adjustment Programs

February 26, 2025Garrett SchmittCoding, HCC, Risk adjustment coding

In the complex world of healthcare, the importance of accurate coding and billing cannot be overstated. For healthcare providers participating in Medicare Risk Adjustment (MRA) programs, coding compliance is crucial in ensuring that patients receive the right care and that healthcare organizations meet legal and financial obligations. Non-compliance can lead to significant financial risks, regulatory…

No More ‘Dabbling’: It’s Time to Embrace Value-Based Care

February 25, 2025Garrett SchmittCoding, FFS, HCC, Risk adjustment coding

Presidential transitions are always a time of great change, but few leaders have ushered in a shift as sweeping as the rewiring of one-seventh of the U.S. economy. President Trump has the opportunity to do just that by doubling down on the health transformation achievements of his first term. A key to success is continuing the…

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