What You Should Know
Diverge Health and Medical Home Network (MHN) PBC announced a definitive merger agreement to form one of the nation's largest value-based care platforms dedicated entirely to safety-net populations and under-resourced communities.The combination establishes one of the largest value-based care platforms in the United States dedicated to underserved communities, entering 2027 with nearly 500,000 attributed Medicaid and Medicare lives and $3 billion in managed medical spend
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Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant
Cedar Gate Survey Reveals 83% of Health Plans Miss VBC Outcomes Due to Fragmented Data
What You Should Know
A national research study conducted by Wakefield Research for Cedar Gate Technologies (an IQVIA business) surveyed 100 senior U.S. health plan executives (VP level and above) across actuarial science, clinical operations, VBC strategy, and IT.The Adoption-Performance Paradox: 83% of payer executives report they are not achieving the cost and quality outcomes they expected from value-based care (VBC), yet 72% intend to continue or expand their alternative payment
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Quantum Health Appoints Dr. Susan Mani as Chief Medical Officer
What You Should Know
Healthcare navigation platform Quantum Health (Dublin, OH) announced on September 15, 2026, the appointment of Dr. Susan Mani as its new Chief Medical Officer (CMO).Dr. Mani brings extensive executive leadership in value-based care and population health, having previously directed clinical and cost-containment initiatives at Humana and regional health system LifeBridge Health.Clinical pedigree includes completing medical school and internal medicine residency at the Johns
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Aligned Marketplace Raises $20M to Scale Independent Primary Care
What You Should Know
Healthcare marketplace Aligned Marketplace secured $20M in Series A funding led by healthcare venture firm Venrock.The platform directly connects self-insured employers and Third-Party Administrators (TPAs) to a national network of independent advanced primary care (APC) and direct primary care (DPC) practices across all 50 states (comprising 3,000+ clinics).Actuarial data from a 2025 Fortune 500 employer program demonstrated a 12% reduction in total cost of care for
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Pearl Health Secures $110M to Scale AI-Driven Value-Based Care Platform for Medicare
What You Should Know
Value-Based Care (VBC) platform innovator Pearl Health has announced a $110M capital raise, combining a $50M Series B equity round led by Andreessen Horowitz with a $60M credit facility from Trinity Capital.Confronting a massive macroeconomic bottleneck where national Medicare expenditures exceed $1 trillion annually, the company helps providers successfully pivot from legacy fee-for-service models to outcomes-driven risk management.The company achieved a rare milestone
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Blue Cross MA Inks Its First Oncology Value-Based Deal with Thyme Care
What You Should Know
Blue Cross Blue Shield of Massachusetts ("Blue Cross") has formalized its first-ever specialty-specific, outcomes-based value-based contract by partnering with cancer care orchestration innovator Thyme Care.The risk-bearing model shifts oncology reimbursement metrics entirely away from traditional, volume-driven fee-for-service loops to prioritize reimbursement tied directly to patient health outcomes.While this marks the plan's first specialized oncology venture, Blue
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Finding the Right Five Percent: How Machine Learning Is Reshaping Care Management
Population Health Has a Precision Problem
Population health programs continue to rely on blunt tools. Many risk stratification approaches emphasize historical utilization—basic risk scores or vendor-generated models that explain who was expensive—rather than identifying emerging clinical risk. These methods struggle to detect deterioration early enough to influence outcomes.
At the same time, care management teams face persistent resource constraints. Organizations cannot provide intensive
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Greater Good Health Raises $20.5M to Expand Value-Based Primary Care Clinics
What You Should Know
The Funding: Greater Good Health has secured a $20.5M Series B led by Allumia Ventures, alongside up to $12.5M in venture debt from HSBC Innovation Banking.The Backers: The round features strategic participation from heavy hitters, including DaVita Venture Group, Granite Financial Holdings (the investment arm of Blue Cross of Idaho), Optum Ventures, and Flare Capital Partners.The Model: The company tackles the primary care physician shortage by deploying a Nurse
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athenahealth 2026 Physician Sentiment Survey: AI Adoption, EHR Efficiency, and VBC Trends
What You Should Know
The Affordability Crisis: According to the newly released 2026 Physician Sentiment Survey from athenahealth’s research hub, athenaInstitute, access to affordable healthcare has surged to become the #1 policy concern among physicians (52%, up a massive 14 points over the last three years), indicating that patient financial strain is now directly impacting clinical delivery.The Technology Paradox: While overall optimism about the U.S. healthcare system remains stagnant at
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Honest Health Raises $140M to Scale Value-Based Care Enablement
What You Should Know
The Funding: Honest Health raises $140M led by NewSpring Healthcare, with participation from K2 HealthVentures, Rubicon Founders, Oak HC/FT, and others.The Mission: The company provides the technology-enabled care coordination, data analytics, and operational infrastructure required for legacy health systems and providers to succeed in value-based care (VBC) and shared-risk payment models.The Pedigree: Honest Health boasts heavy-hitting leadership. CEO Dr. Rob Bessler
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