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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Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant
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
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
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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Reveleer Report Reveals Technology Gaps Hindering Value-Based Care Transformation
What You Should Know:
- Reveleer, in partnership with Mathematica and The Harris Poll, has released the 2025 State of Technology in Value-Based Care (VBC) Report. The report's findings come at a pivotal time, highlighting that while payer and provider alignment on VBC goals is stronger than ever, persistent gaps in technology and execution are stalling progress.
- The report is based on a national survey of 203 payer and provider decision-makers conducted from May 27 to June 10,
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CMS Finalizes TEAM Model: A New Era of Value-Based Surgical Care
What You Should Know:
- The Centers for Medicare & Medicaid Services (CMS) today issued the 2026 Final Rule that officially codifies the Transforming Episode Accountability Model (TEAM), an innovative new blueprint for tech-enabled, outcome-based care payment models.
- Starting in 2026, TEAM will hold hospitals and health systems accountable for the entire episode of care for major surgeries, from admission through 30 days post-discharge, with the goal of reducing
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Arbital Health Secures $31M to Accelerate Value-Based Care Contracting
What You Should Know:
- Arbital Health, a healthcare technology company providing critical infrastructure for providers and payers to successfully manage risk-based contracts secures $31M in Series B funding round led by Valtruis, with participation from existing investors Transformation Capital, Shaper Capital, and Healthy Ventures.
- The investment will expand Arbital Health’s payer and provider facing capabilities, accelerate value-based care contract performance monitoring,
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DecisionRx & MedeAnalytics Partner to Power Value-Based Medication Optimization
What You Should Know:
- MedeAnalytics, a healthcare enterprise data enrichment platform and analytics software-as-a-service (SaaS) leader announced its partnership with DecisionRx, a technology-enabled healthcare services company specializing in medication therapy optimization (MTO).
- The collaboration will allow DecisionRx to expand its ability to quantify and communicate the clinical and economic impact of its work with payers and providers under value-based care contracts,
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athenahealth Released Enhanced Capabilities for Value-Based Care
What You Should Know:
- athenahealth, a provider of network-enabled software and services for healthcare practices nationwide releases new and enhanced capabilities designed to further help practices succeed in value-based care (VBC).
- Practices across athenahealth’s network can now use the athenahealth Marketplace to easily find, choose, and integrate with risk-bearing organizations, including Accountable Care Organizations (ACOs), that align with their goals. The initiative aims
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New Opportunities for Healthcare AI: Decoding the 2026 Medicare Advantage Rate Hike
Last month, the Centers for Medicare & Medicaid Services (CMS) released its 2026 Medicare Advantage (MA) Rate Announcement, projecting a 5.06% average increase in payments to MA plans. That’s a notable jump from the 3.70% increase we saw in 2025. More than just a financial adjustment, this signals growing confidence in the Medicare Advantage model—and with it, growing expectations.
What does this mean simply? Insurance companies offering these plans will receive more government funding,
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