Both the greatest strength and weakness of the ACO shared savings (MSSP) model is its focus on primary care, particularly chronic disease. ACOs have put patients with diabetes, hypertension, and other conditions usually handled through primary care physicians at the center of care coordination, population health, and care management. But as CMS Value-Based Care’s central goal has shifted to cost control, ACOs will need to broaden scope to optimize specialty care. TEAM (Transforming Episode
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Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant
Cityblock Health and Mercy Health Partner to Transform Medicaid Care in Ohio
What You Should Know:
- Cityblock Health, a value-based provider specializing in the complex needs of the Medicaid population, and Mercy Health, part of the Bon Secours Mercy Health system, announced a strategic collaboration in the greater Cincinnati and Toledo areas of Ohio.
- Cityblock will provide care extension services to complement the primary care services already delivered by Mercy Health’s existing provider network.
Wrap-Around Care Coordination
This wrap-around care
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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
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
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
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
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
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
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
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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