The Future of Value-Based Care
A new ten-year experiment called ACCESS is about to test exactly that question — and it could reshape how chronic illness is cared for in America.
The Future of Value-Based Care
A new ten-year experiment called ACCESS is about to test exactly that question — and it could reshape how chronic illness is cared for in America.
Topics: VBC, Value-Based Care, Conference, APG, healthcare, ACCESS
For most of 2024 and 2025, the dominant frame for AI in healthcare was the copilot: AI suggested, a clinician acted. The framing was reassuring. It kept a human in every loop and let institutions defer the hard question of governance, because the AI never did anything a human hadn't already approved.
That framing is breaking down. At the APG Spring Meeting in San Diego this May, 4 organizations — an FQHC, a national VBC enablement company, a Southern California physician group, and UC San Diego Health — described deployments that have moved past copiloting into something more autonomous.
Topics: VBC, Value-Based Care, Conference, AI, APG, healthcare
For roughly a decade, the operating assumption of value-based care has been that you transform outcomes and costs by transforming primary care:
• Attribute the patient to a PCP
• Hand the PCP a panel and a risk arrangement
• Give the care team a gap list
• Let the rest of the system carry on
That model has produced real wins. It’s also produced a generation of risk-bearing organizations that have squeezed most of what they can out of the levers a primary care physician controls and now find themselves staring at the part of the spend they don’t.
Topics: CMS, VBC, Value-Based Care, Conference, APG
For a decade, the question was whether to take risk. Now it's whether your measurement infrastructure can keep up.
About 1,300 medical group executives gathered at AMGA in Las Vegas last month. Most have already committed capital to value-based care. The strategic debate is over. A new one is starting.
Topics: CMS, VBC, Value-Based Care, MIPS Reporting, Conference, AMGA, AI
This blog provides a detailed, visual, and measure-level comparison of 3 key CMS programs under the Quality Payment Program (QPP) framework — traditional MIPS, MIPS Value Pathways (MVPs), and the new Ambulatory Specialty Model (ASM) finalized in the 2026 Physician Fee Schedule Final Rule (CMS-1832-F).
This comparison highlights how CMS is evolving from flexible reporting (MIPS) to aligned reporting (MVPs) to accountable, outcome-based measurement (ASM), with increasing use of digital quality measures (DQMs), FHIR data exchange, and data validation via DQMs.
Topics: Value-Based Care
The Centers for Medicare & Medicaid Services (CMS) have released the 2024 Merit-based Incentive Payment System (MIPS) performance feedback and final scores. The 2024 performance year was characterized by stability, consistency, and restrained adjustments.
Despite modest scoring variations, the 2024 feedback underscores CMS’ strategic redirection toward structured, specialty-aligned models — MIPS Value Pathways (MVPs), the Ambulatory Specialty Model (ASM), and broader CMMI-led innovation frameworks —to drive the next era of value-based reimbursement.
Topics: Value-Based Care
For years, healthcare providers have navigated the complexities of the Merit-based Incentive Payment System (MIPS). They often find it to be a burdensome, one-size-fits-all compliance requirement that feels more like an administrative chore than a true measure of quality.
But the landscape of quality reporting is undergoing its most significant evolution yet. The Centers for Medicare & Medicaid Services (CMS) is shifting away from the broad traditional MIPS framework toward a focused, specialty-specific model: MIPS Value Pathways (MVPs).
Topics: Value-Based Care
CMS recently released updated MIPS quality measure benchmarks that affect how your performance translates into points for 2024 (https://qpp.cms.gov/api/frontend/benchmarks-csv/quality/2024). Below, we summarize what's new and provide complete lists of newly benchmarked measures, categorized by decile completeness.
Topics: Value-Based Care
On Jan. 1, 2026, CMS will launch the Transforming Episode Accountability Model (TEAM), a mandatory 5-year program designed to hold hospitals accountable for both the cost and quality of care delivered around major surgical episodes. TEAM covers 5 high-volume, high-cost procedures, creates two-sided risk, and ties financial performance to outcomes like readmissions, safety, and patient-reported results.
Topics: Value-Based Care
Are you feeling overwhelmed by MIPS reporting requirements? You’re not alone. With the 2025 performance threshold holding steady at 75 points and hundreds of measures to sort through, many providers are turning to MIPS Value Pathways (MVPs) for a more streamlined — and smarter — approach.
Topics: Value-Based Care