--- title: Blog – The Healthmonix Advisor | Value-Based Care description: Value-Based Care | The Healthmonix Advisor - A Blog for healthcare professionals, health systems, and hospitals --- ![logo-light](https://blog.healthmonix.com/hubfs/logo-light.png "logo-light") - [Who we help](https://healthmonix.com/who-we-help/) - [Overview](https://healthmonix.com/who-we-help/) - [ACOs](https://healthmonix.com/acos/) - [Health systems](https://healthmonix.com/health-system/) - [Healthcare technology](https://healthmonix.com/healthcare-technology/) - [Physician practices](https://healthmonix.com/physician-practice/) - [Health system VPs](https://healthmonix.com/health-system-vice-presidents/) - [Chief financial officers](https://healthmonix.com/chief-financial-officers/) - [Chief medical officers](https://healthmonix.com/chief-medical-officers/) - [Chief quality officers](https://healthmonix.com/chief-quality-officers/) - [ACO executive directors](https://healthmonix.com/aco-executive-directors/) - [Solutions](https://healthmonix.com/prism/) - [MIPSpro](https://healthmonix.com/product/mips-pro/) - [Cost](https://healthmonix.com/product/cost/) - [ACO Impact](https://healthmonix.com/product/aco-impact/) - [Analytics](https://healthmonix.com/product/analytics/) - [Ambulatory Specialty Model](https://healthmonix.com/ambulatory-specialty-model-asm/) - [TEAM](https://healthmonix.com/team-program/) - [HealthConnect](https://healthmonix.com/health-connect/) - [Data integration](https://healthmonix.com/dataintegration/) - [Consulting](https://healthmonix.com/consulting-services/) - [Score optimization](https://healthmonix.com/score-optimization/) - [Patient matching](https://healthmonix.com/patient-deduplication-and-matching/) - [Outcomes](https://healthmonix.com/outcomes/) - [Company](https://healthmonix.com/company/) - [Our story](https://healthmonix.com/company/) - [Team](https://healthmonix.com/team/) - [Careers](https://healthmonix.com/healthmonix-careers/) - [Resources](https://healthmonix.com/resources/) - [Help and support](https://healthmonix.com/customer-support/) - [Healthmonix Advisor](https://blog.healthmonix.com/) - [Webinars](https://healthmonix.com/our-webinars/) - [Educational resources](https://healthmonix.com/mips-education/) - [Help and support](https://healthmonix.com/customer-support/) - [Contact us](https://healthmonix.com/contact-us/) - [Measures](https://healthmonix.com/mips-measures/) - [Quality](https://healthmonix.com/mips-measures/mips-quality-measures/) - [CMS specialty sets](https://healthmonix.com/cms-mips-specialty-measure-sets/) - [Promoting Interoperability](https://healthmonix.com/mips-measures/mips-promoting-interoperability-measures/) - [Improvement Activities](https://healthmonix.com/mips-measures/mips-improvement-activities/) - [Cost](https://healthmonix.com/mips-measures/mips-cost-performance-category/) - [Log in](https://healthmonix.com/login/) # Healthmonix Advisor ## [What if Medicare paid for results, not visits?](https://blog.healthmonix.com/what-if-medicare-paid-for-results-not-visits) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on June 15, 2026 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/Access%20Blog%20Featured%20Image.png)](https://blog.healthmonix.com/what-if-medicare-paid-for-results-not-visits) 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. [Read More](https://blog.healthmonix.com/what-if-medicare-paid-for-results-not-visits) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/what-if-medicare-paid-for-results-not-visits#comments-listing) Topics: [VBC](https://blog.healthmonix.com/topic/vbc), [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care), [Conference](https://blog.healthmonix.com/topic/conference), [APG](https://blog.healthmonix.com/topic/apg), [healthcare](https://blog.healthmonix.com/topic/healthcare), [ACCESS](https://blog.healthmonix.com/topic/access) ## [Beneath the waterline — Healthcare's shift to AI](https://blog.healthmonix.com/beneath-the-waterline-healthcares-shift-to-ai) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on June 8, 2026 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/Beneath-the-waterline-A.png)](https://blog.healthmonix.com/beneath-the-waterline-healthcares-shift-to-ai) 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. [Read More](https://blog.healthmonix.com/beneath-the-waterline-healthcares-shift-to-ai) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/beneath-the-waterline-healthcares-shift-to-ai#comments-listing) Topics: [VBC](https://blog.healthmonix.com/topic/vbc), [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care), [Conference](https://blog.healthmonix.com/topic/conference), [AI](https://blog.healthmonix.com/topic/ai), [APG](https://blog.healthmonix.com/topic/apg), [healthcare](https://blog.healthmonix.com/topic/healthcare) ## [The 80% problem: Why value-based care will be won in specialty](https://blog.healthmonix.com/the-80-percent-problem-why-value-based-care-will-be-won-in-specialty) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on June 1, 2026 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/healthmonix_blog_thumbnail.png)](https://blog.healthmonix.com/the-80-percent-problem-why-value-based-care-will-be-won-in-specialty) 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. [Read More](https://blog.healthmonix.com/the-80-percent-problem-why-value-based-care-will-be-won-in-specialty) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/the-80-percent-problem-why-value-based-care-will-be-won-in-specialty#comments-listing) Topics: [CMS](https://blog.healthmonix.com/topic/cms), [VBC](https://blog.healthmonix.com/topic/vbc), [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care), [Conference](https://blog.healthmonix.com/topic/conference), [APG](https://blog.healthmonix.com/topic/apg) ## [The VBC Bottleneck Has Changed](https://blog.healthmonix.com/the-vbc-bottleneck-has-changed) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on May 19, 2026 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/Screenshot%202026-05-18%20125628.png)](https://blog.healthmonix.com/the-vbc-bottleneck-has-changed) 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. [Read More](https://blog.healthmonix.com/the-vbc-bottleneck-has-changed) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/the-vbc-bottleneck-has-changed#comments-listing) Topics: [CMS](https://blog.healthmonix.com/topic/cms), [VBC](https://blog.healthmonix.com/topic/vbc), [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care), [MIPS Reporting](https://blog.healthmonix.com/topic/mips-reporting), [Conference](https://blog.healthmonix.com/topic/conference), [AMGA](https://blog.healthmonix.com/topic/amga), [AI](https://blog.healthmonix.com/topic/ai) ## [From MIPS to MVPs to ASM: How CMS is redefining quality measurement in the 2026 final rule](https://blog.healthmonix.com/mips-to-mvps-to-asm-2026-final-rule) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on November 6, 2025 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/Turquoise%20and%20White%20Professional%20Healthcare%20Banner%20(1)-2.png)](https://blog.healthmonix.com/mips-to-mvps-to-asm-2026-final-rule) 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).  - Traditional MIPS (2017–present): Broad, clinician-driven program allowing flexibility in measure selection but limited comparability across specialties.   - MIPS Value Pathways (MVPs, 2023–2026): Transitional structure to align measures by specialty or condition, improving comparability and interoperability.  - Ambulatory Specialty Model (ASM, launching 2027): Mandatory, condition-specific model targeting **heart failure and low back pain specialists** in select CBSAs. 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.  [Read More](https://blog.healthmonix.com/mips-to-mvps-to-asm-2026-final-rule) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/mips-to-mvps-to-asm-2026-final-rule#comments-listing) Topics: [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care) ## [2024 MIPS performance results and 2026 payment adjustments](https://blog.healthmonix.com/2024-mips-performance-results-and-2026-payment-adjustments) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on October 30, 2025 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/Blog%20graphic.png)](https://blog.healthmonix.com/2024-mips-performance-results-and-2026-payment-adjustments) 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.  [Read More](https://blog.healthmonix.com/2024-mips-performance-results-and-2026-payment-adjustments) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/2024-mips-performance-results-and-2026-payment-adjustments#comments-listing) Topics: [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care) ## [Are you ready for the biggest shift in MIPS reporting? Why your practice needs an MVP strategy — now.](https://blog.healthmonix.com/shift-to-mvps) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on October 9, 2025 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/MVP%20shift.png)](https://blog.healthmonix.com/shift-to-mvps) 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)**.  [Read More](https://blog.healthmonix.com/shift-to-mvps) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/shift-to-mvps#comments-listing) Topics: [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care) ## [Updated 2024 MIPS quality benchmarks: What providers need to know for 2024 final scores and 2025 performance tracking](https://blog.healthmonix.com/why-some-quality-measures-had-no-benchmark-2024) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on October 2, 2025 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/ChatGPT%20Image%20Oct%201%2c%202025%2c%2002_17_14%20PM.png)](https://blog.healthmonix.com/why-some-quality-measures-had-no-benchmark-2024) 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](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.  [Read More](https://blog.healthmonix.com/why-some-quality-measures-had-no-benchmark-2024) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/why-some-quality-measures-had-no-benchmark-2024#comments-listing) Topics: [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care) ## [TEAM is mandatory. Success isn’t. What hospitals must do now to prepare. ](https://blog.healthmonix.com/blog/team-mandatory-hospital-preparation-2026) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on September 26, 2025 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/TEAM-1.png)](https://blog.healthmonix.com/blog/team-mandatory-hospital-preparation-2026) 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.  [Read More](https://blog.healthmonix.com/blog/team-mandatory-hospital-preparation-2026) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/blog/team-mandatory-hospital-preparation-2026#comments-listing) Topics: [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care) ## [MIPS MVPs: Your complete guide to choosing the right value pathway in 2025](https://blog.healthmonix.com/blog/mips-mvp-selection) Posted by [Lauren Patrick](https://blog.healthmonix.com/author/lauren-patrick) on September 10, 2025 - [Tweet](https://twitter.com/share) [![](https://blog.healthmonix.com/hubfs/ChatGPT%20Image%20Sep%209%2c%202025%2c%2003_33_12%20PM.png)](https://blog.healthmonix.com/blog/mips-mvp-selection) 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.  [Read More](https://blog.healthmonix.com/blog/mips-mvp-selection) 0 Comments [Click here to read/write comments](https://blog.healthmonix.com/blog/mips-mvp-selection#comments-listing) Topics: [Value-Based Care](https://blog.healthmonix.com/topic/value-based-care) [All posts](https://blog.healthmonix.com/all) [Next](https://blog.healthmonix.com/topic/value-based-care/page/2) ### Subscribe Here! ### Search the Healthmonix Advisor - [MACRA & MIPS (132)](https://blog.healthmonix.com/topic/macra-mips) - [Policy (77)](https://blog.healthmonix.com/topic/policy) - [PRO Tips (57)](https://blog.healthmonix.com/topic/pro-tips) - [CMS (34)](https://blog.healthmonix.com/topic/cms) - [Quality Performance Category (32)](https://blog.healthmonix.com/topic/quality-performance-category) - [Industry insights (29)](https://blog.healthmonix.com/topic/industry-insights) - [VBC (20)](https://blog.healthmonix.com/topic/vbc) - [ACO (19)](https://blog.healthmonix.com/topic/aco) - [Healthmonix (19)](https://blog.healthmonix.com/topic/healthmonix) - [MIPS Reporting (19)](https://blog.healthmonix.com/topic/mips-reporting) - [Cost Performance Category (16)](https://blog.healthmonix.com/topic/cost-performance-category) - [Health IT (16)](https://blog.healthmonix.com/topic/health-it) - [APMs (15)](https://blog.healthmonix.com/topic/apms) - [Eligibility (15)](https://blog.healthmonix.com/topic/eligibility) - [Interoperability (14)](https://blog.healthmonix.com/topic/interoperability) - [Value-Based Care (14)](https://blog.healthmonix.com/topic/value-based-care) - [IA Performance Category (11)](https://blog.healthmonix.com/topic/ia-performance-category) - [ROI (11)](https://blog.healthmonix.com/topic/roi) - [COVID-19 (10)](https://blog.healthmonix.com/topic/covid-19) - [ACI Performance Category (9)](https://blog.healthmonix.com/topic/aci-performance-category) - [EHR (9)](https://blog.healthmonix.com/topic/ehr) - [PQRS (9)](https://blog.healthmonix.com/topic/pqrs) - [APM Performance Pathway (7)](https://blog.healthmonix.com/topic/apm-performance-pathway) - [Hospitals & Health Systems (7)](https://blog.healthmonix.com/topic/hospitals-health-systems) - [MIPS CQMs (7)](https://blog.healthmonix.com/topic/mips-cqms) - [PI Performance Category (6)](https://blog.healthmonix.com/topic/pi-performance-category) - [Bundled Payments (5)](https://blog.healthmonix.com/topic/bundled-payments) - [MIPS Value Pathways (5)](https://blog.healthmonix.com/topic/mips-value-pathways) - [Small Practice (5)](https://blog.healthmonix.com/topic/small-practice) - [2021 PFS Proposed Rule (4)](https://blog.healthmonix.com/topic/2021-pfs-proposed-rule) - [Accountable Care Organization (4)](https://blog.healthmonix.com/topic/accountable-care-organization) - [Conference (4)](https://blog.healthmonix.com/topic/conference) - [Physician Compare (4)](https://blog.healthmonix.com/topic/physician-compare) - [2022 PFS Final Rule (3)](https://blog.healthmonix.com/topic/2022-pfs-final-rule) - [APG (3)](https://blog.healthmonix.com/topic/apg) - [Administrative Burden (3)](https://blog.healthmonix.com/topic/administrative-burden) - [RCM (3)](https://blog.healthmonix.com/topic/rcm) - [certified electronic health record technology (3)](https://blog.healthmonix.com/topic/certified-electronic-health-record-technology) - [eCQMs (3)](https://blog.healthmonix.com/topic/ecqms) - [2015 Edition CEHRT (2)](https://blog.healthmonix.com/topic/2015-edition-cehrt) - [2021 PFS Final Rule (2)](https://blog.healthmonix.com/topic/2021-pfs-final-rule) - [2022 PFS Proposed Rule (2)](https://blog.healthmonix.com/topic/2022-pfs-proposed-rule) - [2023 PFS Final Rule (2)](https://blog.healthmonix.com/topic/2023-pfs-final-rule) - [2023 Proposed Rule (2)](https://blog.healthmonix.com/topic/2023-proposed-rule) - [AI (2)](https://blog.healthmonix.com/topic/ai) - [Medicare Shared Savings Program (2)](https://blog.healthmonix.com/topic/medicare-shared-savings-program) - [Merit-based Incentive Payment System (2)](https://blog.healthmonix.com/topic/merit-based-incentive-payment-system) - [Promoting Interoperability (2)](https://blog.healthmonix.com/topic/promoting-interoperability) - [health equity (2)](https://blog.healthmonix.com/topic/health-equity) - [healthcare (2)](https://blog.healthmonix.com/topic/healthcare) - [2015 (1)](https://blog.healthmonix.com/topic/2015) - [2015 Edition Cures Update (1)](https://blog.healthmonix.com/topic/2015-edition-cures-update) - [2015 Edition Cures Update certification (1)](https://blog.healthmonix.com/topic/2015-edition-cures-update-certification) - [2023 MIPS Reporting for Large Practices (1)](https://blog.healthmonix.com/topic/2023-mips-reporting-for-large-practices) - [ACCESS (1)](https://blog.healthmonix.com/topic/access) - [AMGA (1)](https://blog.healthmonix.com/topic/amga) - [Gaps in Care - New Quality Measures (1)](https://blog.healthmonix.com/topic/gaps-in-care-new-quality-measures) - [Health Equity Adjustment (1)](https://blog.healthmonix.com/topic/health-equity-adjustment) - [Improvement Activities (1)](https://blog.healthmonix.com/topic/improvement-activities) - [MIPS Cost (1)](https://blog.healthmonix.com/topic/mips-cost) - [MVPs (1)](https://blog.healthmonix.com/topic/mvps) - [NPPES (1)](https://blog.healthmonix.com/topic/nppes) - [Practice Reopening (1)](https://blog.healthmonix.com/topic/practice-reopening) - [Primary Care First (1)](https://blog.healthmonix.com/topic/primary-care-first) - [Strategic Health IT Partnerships (1)](https://blog.healthmonix.com/topic/strategic-health-it-partnerships) - [billing companies (1)](https://blog.healthmonix.com/topic/billing-companies) - [submission (1)](https://blog.healthmonix.com/topic/submission) - [universal foundation of quality measures (1)](https://blog.healthmonix.com/topic/universal-foundation-of-quality-measures) see all Search ### Recent Posts ## Outcomes focused: Improving the quality and delivery of care ![logo-icon](https://blog.healthmonix.com/hubfs/logo-icon.png "logo-icon") © 2024 Healthmonix. All Rights Reserved.