The metrics redefining care access

October 23, 2025Garrett SchmittCCM, Chronic Care, HCC

Across hospitals and health systems, COOs remain focused on improving patient access. As many organizations face growing demand and a need for additional capacity, they are implementing various strategies, including expanding their ambulatory networks and launching telehealth programs. How have their efforts to track access — such as new dashboards and top operational key performance indicators— evolved in 2025?…

CMS walks back Medicare payment pause

October 16, 2025Garrett SchmittCCM, Chronic Care, HCC

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…

A new test for value-based care: What to know about CMS’ TEAM

September 17, 2025Garrett SchmittCCM, Chronic Care, HCC

On Jan. 1, CMS will begin implementation of a new alternative payment system for select hospitals. The Transforming Episode Accountability Model will hold participating hospitals responsible for the care quality, costs and post-acute coordination associated with five surgical procedures. The model is intended to mark a shift toward shared accountability and a test of whether healthcare providers…

What you need to know about coding in value-based care

September 8, 2025Garrett SchmittFFS, HCC

Value-based care (VBC) continues to become a mainstream reality for health care providers. While a patient may not notice a difference between a value-based or a fee-for-service (FFS) approach, there is a stark difference for physician practices. It represents a complete paradigm shift. VBC is a necessary approach that allows physicians to care for the…

Value-based care scores of US News’ top 50 heart hospitals

September 3, 2025Garrett SchmittCCM, Chronic Care, HCC

Out of U.S. News & World Report’s top 50 heart hospitals, Phoenix-based Mayo Clinic Arizona and Rochester, Minn.-based Mayo Clinic had the highest total performance scores in CMS’ Hospital Value-Based Purchasing program for fiscal 2025, at 51.5 and 51.08, respectively. Through its HVBP program, CMS pays hospitals for “inpatient acute care services based on the quality of care, not just…

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…

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