Tag: Value-Based Care

Medicare Advantage Growth in Dialysis Patients Raises Care and Policy Challenges

Rising Medicare Advantage enrollment among dialysis patients following the 21st Century Cures Act presents new challenges in care coordination, provider access, and regulatory oversight, impacting insurers and policymakers.

Home Health Providers Navigate Challenges in Shifting to Value-Based Reimbursement

Home health providers face challenges shifting from fee-for-service to value-based care due to payer demands and regulatory pressures. Innovative payment models and care delivery adaptations are key to success.

TEAM Model Poised to Reshape Post-Acute Care with Varying Provider Readiness

Skilled nursing and hospital readiness varies as the CMS-initiated TEAM bundled payment model launches in 2026, impacting post-acute care coordination, financial risk, and value-based contracting in U.S. healthcare.

2025 Payer + Provider Summit Highlights AI, Value-Based Care, and Community Partnerships

Insights from the 2025 Payer + Provider Summit on AI-driven care, value-based models, community partnerships, and the need for stable federal policies to advance primary and preventive care.

Medicare Advantage Leads with Integrated Clinical Strategy and Member Engagement

Medicare Advantage plans are advancing outcomes by integrating clinical excellence, AI-driven engagement, health literacy, and community partnerships to support holistic member care.

Stellar Health's MSSP ACO Achieves $5M Medicare Savings with Tech-Enabled Model

Stellar Health's MSSP ACO surpasses Medicare average savings with $5M saved in 2024, leveraging tech-enabled micro-incentives to improve provider performance and patient outcomes in value-based care.

Growth in Special Needs Plans (SNPs) Drives Medicare Advantage Enrollment

Special Needs Plans (SNPs) are driving significant growth in Medicare Advantage enrollment in 2025, with chronic condition and dual-eligible SNPs leading gains. Institutional SNPs decline amid evolving care models.

Community Paramedics Reduce Hospital Readmissions Under Medicare Penalties

Community paramedics and post-discharge monitoring reduce hospital readmissions and Medicare penalties, improving patient outcomes and cost efficiency in Minnesota hospitals.

Medicare Advantage Challenges and Opportunities for Skilled Nursing Providers

Trilogy Health Services CMO discusses Medicare Advantage's impact on skilled nursing, focusing on administrative challenges, appeals, and value-based care opportunities. Insights on I-SNP partnerships and payment simplification for providers.

AI-Driven Predictive Analytics Enhance Diabetes Care and Reduce Medicare Costs

Explore how AI-powered predictive analytics improve diabetes management and reduce Medicare costs through personalized patient adherence interventions.