As the Centers for Medicare & Medicaid Services moves forward with the Transforming Episode Accountability Model (TEAM), hospitals are taking on financial accountability for Medicare’s most complex and costly surgical episodes. Hospitals that don’t take action to achieve better patient outcomes could find themselves owing Medicare money.
While TEAM shifts meaningful risk to hospitals, it also creates an opportunity often missing in value-based care: true collaboration with
Read More
Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant
Frist Cressey Ventures Raises $425M Fund to Invest in AI-Native Care
What You Should Know
The Raise: Frist Cressey Ventures (FCV) has closed an oversubscribed $425M Fund IV, bringing its total assets under management to nearly $1 billion.The Strategy: The new fund will focus on early-stage healthcare companies transforming care delivery, with a specific emphasis on AI-native business models and tech-enabled services.The "Moat": FCV’s strategic Limited Partners (LPs)—including The Cigna Group, MedStar Health, and OhioHealth—provide healthcare to over 50% of the
Read More
Atlas Oncology Raises $28M to Take “Full Risk” on Patient Costs
What You Should Know
The Raise: Atlas Oncology Partners has closed a $28M Series A financing round led by Flare Capital Partners, with significant backing from Rubicon Founders.The Model: Atlas isn't just a software vendor; it is a value-based care platform that assumes full medical cost risk. This means they are financially responsible for the total cost of a patient's cancer journey, aligning their incentives with payers and patients.The Strategy: The company embeds interdisciplinary care
Read More
The Interoperability Bridge: How HIEs Secure CMS 2026 Compliance for Payers
As healthcare costs continue to increase and patients demand more from their insurance coverage, there’s rising pressure to provide higher-quality care more efficiently than ever before. The expectations for healthcare payers to achieve the Triple Aim objectives—that is, better patient experiences and improved population health at lower costs—demand that we all become more resourceful in our approach to care.
It's clear that health plans and hospital systems can’t achieve these ambitious
Read More
The ‘Volume’ Era is Dead: Humana Data Proves Value-Based Care Cuts Admissions by 24%
What You Should Know
The Report: Humana’s newly released Value-Based Care By the Numbers Report, reveals that Medicare Advantage members in value-based care (VBC) arrangements are seeing significantly better outcomes than those in traditional models.The Data: The impact is measurable and massive: VBC patients experienced 24.3% fewer hospital admissions and 13.4% fewer emergency room visits in 2024.The Shift: The report validates the industry's transition from "reactive" fee-for-service
Read More
Why Value-Based Care Will Fail Without a Dynamic Tech Stack
Value-based care (VBC) is a fundamental shift from volume-based, fee-for-service models to outcome-driven healthcare delivery. It characteristically requires providers to be far more dynamic about patient care, assessing risk and working collaboratively with other providers for individual patient-centered goals. However, at its full extent, this ask of providers is likely beyond what the average health organization technology stack can facilitate.
VBC providers must manage risk, improve
Read More
From Fragmentation to Clarity: How Ambient AI Powers Value-Based Care
As healthcare organizations deepen their investments in value-based care, one obstacle continues to stymie progress: incomplete visibility into the patient’s health status. The problem isn’t limited to a single source, such as claims data, though claims are often blamed. Rather, it’s the fragmented nature of healthcare data itself. Patient information is dispersed across a patchwork of systems—EHRs, HIEs, scanned documents, specialist consults, diagnostic reports, lab results, payer files, and
Read More
Surviving the One Big Beautiful Bill Act: Technology Strategies for Safety-Net Providers Facing Medicaid Cuts
Financial challenges are not new to healthcare. A perfect storm of converging trends has left many organizations operating within razor-thin margins in recent years.
For safety-net providers, the latest financial uncertainties introduced by the One Big Beautiful Bill Act present yet another hurdle. Many financial executives may fear making the wrong move and choose to “freeze” in response to Medicaid funding cuts that will equate to nearly $800 million.
Yet inaction is likely
Read More
The VBC Paradox: Why Hospitals Are Doubling Down on Value-Based Care While Revenue at Risk Lags
What You Should Know:
- A new report from Sage Growth Partners reveals a striking disconnect in the healthcare industry: while only 20% of C-suite leaders believe progress has been made in value-based care (VBC) recently, 77% plan to increase their participation in these models over the next two years.
- The "plot twist" indicates that despite operational hurdles and low revenue exposure today, hospital executives view VBC as essential for long-term financial survival. The data
Read More
More Safe Days at Home: A Call to Redesign Pediatric Care
For children with special health care needs, the line between stability and crisis is razor-thin. A quiet day at home can quickly spiral into an unplanned hospital admission. Even during moments of calm, families live with constant anxiety that a small change in condition could trigger the next emergency.
It shouldn’t be that way.
Time at home should be safe and supported, not a fragile pause between hospitalizations. Yet today’s healthcare system still defaults to crisis response,
Read More
