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…
Key Takeaways Persistent underperformance of prior oncology VBC models reflects failure to measurably improve outcomes while lowering total cost, sustaining skepticism despite ongoing urgency to redesign care delivery. Population-based infrastructure leveraging claims, HIE feeds, onboarding assessments, ePROs, and predictive modeling enables risk stratification and earlier intervention to prevent avoidable ED use and admissions. Value-based care…
Significant differences in maternal health outcomes were found in the Massachusetts Medicaid accountable care organization (ACO) program based on the ACO’s organizational structure, according to a recent investigation published in JAMA Network Open.1 The study analyzed 2 distinct models implemented by the state in 2018: model A, a partnership between a health system and a managed…
WASHINGTON, October 8, 2025 (Newswire.com) – The healthcare industry’s transition toward value-based care continues to accelerate, driven by analytics, automation, and interoperability platforms purpose-built for accountable care delivery. The national survey conducted by Black Book Research identified the top-rated software, managed service, and consulting firms supporting Accountable Care Organizations (ACOs), provider networks, and risk-bearing entities. The…
The last time The American Journal of Managed Care (AJMC) hosted a meeting in Princeton, New Jersey, was 2014, as millions of Americans were gaining health coverage under the Affordable Care Act—some for the first time in their lives. Across health care, people were trying to grasp a new concept called value-based care, which focused on delivering…
Accountable care organizations (ACOs) are a significant innovation in health care delivery and payment. ACOs, formed by various health care providers, including acute care hospitals, expanded through commercial health plans and Medicaid agencies even before Medicare ACOs grew under the Affordable Care Act. CMS launched the Medicare Shared Savings Program (MSSP) and Pioneer ACOs in…
In value-based care models, pharmacists play an important role in multidisciplinary team care in selecting cost-effective treatments and managing adherence to prevent hospitalizations and emergency department (ED) visits, explained Eileen Peng, PharmD, vice president, chief administrator, and pharmacy officer, Astera Cancer Care. Full Article
First catheters, now skin substitutes—and more areas of anomalous medical billing will continue to pop up, requiring data vigilance and collaboration on the part of accountable care organizations (ACOs), according to speakers at the National Association of ACOs (NAACOS) Spring 2025 Conference. The identification of these areas potentially signaling fraud aligns with the Trump administration’s…
The rapid expansion of the accountable care organization (ACO) program implemented by CMS in 2012 has resulted in different types of health care organizations participating in this value-based payment model.1,2 The ACO model encourages providers to coordinate patient care across the continuum and financially rewards participants through shared savings for containing costs while improving the quality…
Many health systems struggle to achieve cost savings in value-based care due to care management gaps and fragmented care delivery, particularly for patients with complex needs. To address these silos, health systems must adopt proactive, continuous care management with standardized communications and leadership support across all organizational levels. This can be accomplished by mapping care…