How AI-driven functional precision medicine unlocks personalized cancer therapy

March 16, 2026Garrett SchmittNo Commentschange management strategy, gap analysis, healthcare technology, value-based care, vbc

Despite decades of progress in oncology, ranging from molecular diagnostics to targeted therapies, cancer remains one of medicine’s most complex and costly challenges. While genomic sequencing and AI-assisted analytics have improved disease classification, biomarker identification, and the discovery of drugs that may help, most patients are still treated using standardized protocols driven by population-level data rather…

2025 Medicare FFS catheter billing anomalies and ACO implications | Milliman MedInsight

March 9, 2026Garrett SchmittNo Commentsvalue-based care, vbc

While reviewing claims data patterns in quarter three (Q3) of 2025, Milliman observed a significant increase in paid amounts for claims billed under Healthcare Common Procedure Coding System (HCPCS) code A4352—intermittent urinary catheter; coudé (curved) tip, with or without coating (Teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each—that deviates from historical trends and could have…

The AI leadership gap threatening value-based care

January 26, 2026Garrett SchmittNo Commentschange management strategy, gap analysis, healthcare technology, value-based care, vbc

The healthcare industry is at a critical inflection point and the promise of value-based care is at risk due to operational complexity and clinician burnout. AI offers a potential lifeline to streamline processes and restore focus on patient care. However, widespread adoption is stalling. Concerns around trust, transparency, and usability are slowing progress. This isn’t just…

The post-acute problem: The biggest blind spot in value-based care

January 13, 2026Garrett SchmittNo Commentschange management strategy, gap analysis, healthcare technology, value-based care, vbc

When the Centers for Medicare & Medicaid Services (CMS) launched the Transforming Episode Accountability Model (TEAM) and the AIM for Health Equity and Accountable Care Growth (AHEAD) model, it wasn’t tinkering with policy at the margins — it was redefining what hospitals are accountable for. The new rules make one truth unavoidable: the hospital’s responsibility doesn’t…

Why achieving value-based care requires more advanced IT solutions

September 19, 2025Garrett SchmittNo Commentschange management strategy, gap analysis, healthcare technology, value-based care, vbc

It takes a village. Moving toward value-based care (VBC) in the U.S. healthcare system requires engagement and cooperation from multiple players. Stakeholders include accountable care organizations, social service and community-based organizations, multiple payers, and a range of providers. Ideally, these groups and individuals work seamlessly together to create multiple policies and payment strategies inherent to VBC…

ACO REACH PY2025 changes: What do they mean for my ACO?

November 26, 2024Garrett SchmittNo CommentsACO, ACOs, value-based care, vbc

In late July, the Center for Medicare and Medicaid Innovation (CMMI) announced updates to the ACO Realizing Equity, Access, and Community Health (REACH) model beginning in performance year (PY) 2025.1 This announcement coincided with the recent publication by CMMI of the Global and Professional Direct Contracting (GPDC) Model PY2022 Evaluation Report, which cites some of the early…

VBC Contract Management with Healthcare Analytics | Milliman MedInsight

November 26, 2024Garrett SchmittNo Commentsvalue-based care, vbc

The transition towards value-based care (VBC) is rapidly reshaping the healthcare landscape. While this shift holds immense promise for improving patient outcomes and reducing costs, it also presents a unique set of challenges that demand careful consideration for successful contract negotiations and management. In this blog post Milliman MedInsight product manager, Umang Gupta, explains the…

Report Identifies Keys to Data Integration for Value-Based Care

August 4, 2022Garrett Schmittcare coordination, Data, data integration, health data, point of care, Population Health, value-based care, vbc

A new report, funded by the Department of Health and Human Services’ Assistant Secretary for Planning and Evaluation and the Office of the National Coordinator for Health IT, summarizes interviews with executives at 21 organizations involved in value-based care. The report focuses on the barriers to and facilitators of data integration in support of value-based…

3 Steps to Enter the Value-Based Care Space

July 30, 2022Garrett Schmittvalue-based care, vbc

Value-based care (VBC) is quickly becoming the future of healthcare. By 2030, CMS expects 100% of traditional Medicare beneficiaries to be treated by a provider in a value-based care model. The objective is to improve the quality of patient care based on specific measures, such as lowering the overall cost of care, reducing hospital readmissions,…

Value-based care creating a new era of interoperability

May 19, 2022Garrett SchmittInteroperability, value-based care, vbc

Interoperability in healthcare, it would seem, is at an important inflection point. Rules around data exchange have been around for years, and regulate what patient information gets shared between payers, providers and the patients themselves. There are also standards around how that information is shared, and the forms it can take. But the transition to…

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