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Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant

Reinventing Value-Based Care Program Administration with AI

by Leslie Vasquez, Federal Value-Based Care Lead at Accenture Federal Services 11/12/2025 Leave a Comment

Reinventing Value-Based Care Program Administration with AI

Implementing a new VBC program in healthcare requires cross-functional support and overcoming numerous challenges. Simplification opportunities exist to address pain points for program administrators such as rigorous research, ROI assessment, and stakeholder engagement. Manual processes, including participant recruitment, financial modeling, program integrity management, and technical assistance can benefit from technology to streamline and automate tasks, allowing skilled resources to focus on
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Vatica Health Merges with Cozeva for Value-Based Care Enablement

by Jasmine Pennic 11/05/2025 Leave a Comment

Vatica Health Merges with Cozeva for Value-Based Care Enablement

What You Should Know:  - Vatica Health (“Vatica”), a Frazier Healthcare portfolio company and a leader in prospective risk adjustment and clinical quality solutions, today announced the closing of its merger with Cozeva, a premier SaaS platform focused on value-based care (VBC) enablement.  - The strategic combination unites Vatica’s #1-rated Best in KLAS risk adjustment platform with Cozeva’s #1-rated Best in KLAS quality platform, significantly accelerating their collective mission
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Why Value-Based Care Fails to Reward LTPAC Providers Today

by Eugene Gonsiorek, PhD, VP of Clinical Regulatory Standards at PointClickCare 10/30/2025 Leave a Comment

Why Value-Based Care Fails to Reward LTPAC Providers Today

The chorus of voices singing the praises of value-based care is growing ever louder. But in LTPAC, it still feels like the system’s asking providers to do more—with less—and faster than ever. For the past 25 years, financial strategy in long-term and post-acute care has been tied to two things: occupancy and payer mix. Around 70% of residents are covered by Medicaid. The rest—split between Medicare fee-for-service, Medicare Advantage, and private pay—bring in higher rates, especially
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Cairns Health Acquires Together by Renee to Integrate AI Vision into Voice-Based Senior Care

by Fred Pennic 10/17/2025 Leave a Comment

Cairns Health Acquires Together by Renee to Integrate AI Vision into Voice-Based Senior Care

What You Should Know:  - Cairns Health, a provider of digital health solutions for seniors and individuals with chronic conditions announced the strategic acquisition of Together by Renee, an award-winning, AI-powered healthcare app from SixD Inc.. Financial details of the acquisition were not disclosed.  - The move deepens Cairns’ commitment to simplifying complex healthcare tasks through technology that empowers patients and their caregivers. Integrating AI Vision and Voice
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M&A: Evolent Health Sells Primary Care Business to Privia Health for $113M

by Fred Pennic 09/26/2025 Leave a Comment

M&A: Evolent Health Sells Primary Care Business to Privia Health for $113M

What You Should Know:  - Evolent Health, Inc., a company focused on improving health outcomes for people with complex conditions, has reached a definitive agreement to sell its value-based primary care business, Evolent Care Partners (ECP), to Privia Health Group, Inc..  - ECP is a major participant in the Medicare Shared Savings Program (MSSP), partnering with over 1,000 physicians to serve more than 120,000 members across the nation. Transaction Details and Financial
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Daymark Health Secures $20M to Scale Value-Based Cancer Care

by Fred Pennic 09/26/2025 Leave a Comment

Daymark Health Secures $20M to Scale Value-Based Cancer Care

What You Should Know:  - Daymark Health, a company dedicated to redefining the cancer care experience secures $20M in Series A funding round led by Healthier Capital and Blue Venture Fund, with continued participation from existing investors including Yosemite, Maverick Ventures, and Oncology Ventures.  - The investment will allow Daymark Health to continue scaling its cancer care platform, forge new partnerships with health plans and providers, and bring its innovative technology to
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Unlocking $90M in Revenue: The Value-Based Imperative for OR Optimization

by Dr Nadine Hachach-Haram Founder and CEO of Proximie 09/18/2025 Leave a Comment

Unlocking $90M in Revenue: The Value-Based Imperative for OR Optimization

Over the past decade, the Center for Medicare & Medicaid Services (CMS) has been steadily reshaping how U.S. healthcare is funded – shifting from a fee-for-service model to one that emphasizes value, outcomes, and efficiency. Starting with the Affordable Care Act in 2010 and accelerating with initiatives like the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, CMS introduced models such as the Merit-based Incentive Payment System (MIPS), the Accountable Care Organization (ACO)
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Strive Health Raises $550M to Expand Value-Based Kidney Care with AI and Analytics

by Fred Pennic 09/09/2025 Leave a Comment

Strive Health Raises $550M to Expand Value-Based Kidney Care with AI and Analytics

What You Should Know:  - Strive Health, a provider of value-based kidney care announced it has secured $550M, consisting of a $300M Series D equity round and $250M in debt financing.  - The equity funding was led by New Enterprise Associates (NEA), with additional investments from a syndicate of leading financial institutions, including CVS Health Ventures, CapitalG, and BlackRock, Inc.. Hercules Capital led the debt financing. - The funding will enable Strive and its team of
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Data-Driven VBC: How Tech and AI Are Transforming Value-Based Care

by Kimberly Smith, Senior Clinical Solutions Executive at Net Health 09/08/2025 Leave a Comment

Data-Driven VBC: How Tech and AI Are Transforming Value-Based Care

The transition from fee-for-service to value-based care (VBC) puts continued pressure on the healthcare industry, especially as organizations push to remain relevant in a competitive environment while improving patient outcomes. The primary goal of VBC is to enhance clinical results and reduce overall healthcare costs, aligning care delivery with the evolving expectations of payers and patients. Learning to utilize comprehensive, real-time, and actionable data from advanced technology will fully
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Humana Report Highlights Better Outcomes for Heart Failure Patients in Value-Based Care

by Fred Pennic 08/25/2025 Leave a Comment

Humana Report Highlights Better Outcomes for Heart Failure Patients in Value-Based Care

What You Should Know:  - Humana Inc. has released a new Value-Based Care Issue Brief with findings that indicate value-based care delivers a higher quality of care and better medication adherence to evidence-based medicine for Medicare Advantage patients diagnosed with heart failure. Impact of Heart Failture Heart failure is a growing concern, with 11.4 million Americans expected to be diagnosed with the condition by 2050. Patients with heart failure are more likely to be
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