Navigating population health with clarity: Dr. Kodama’s expert tips for success in value-based healthcare
The shift toward value-based care (VBC) is transforming how services are delivered, focusing on improving patient outcomes and engagement while reducing costs. Success in this model depends on understanding your population, managing their health proactively, and coordinating care effectively. Meet Dr. Christopher Kodama, Chief Medical Officer at Milliman MedInsight. With a clinical background in pediatric … Navigating population health with clarity: Dr. Kodama’s expert tips for success in value-based healthcare
CMS 2025 RADV audit expansion: Key changes and what they mean to MA plans
In a significant move announced on May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) revealed plans to initiate annual Risk Adjustment Data Validation (RADV) audits for all Medicare Advantage (MA) plans. In this memo, CMS Administrator, Dr. Mehmet Oz, is quoted as saying “We are committed to crushing fraud, waste and abuse … CMS 2025 RADV audit expansion: Key changes and what they mean to MA plans
Sustaining payer success: Key themes from Becker’s Payer Issues Roundtable
In an era shaped by unpredictable shifts in the healthcare landscape, innovative approaches took center stage at Becker’s Payer Issues Roundtable Spring 2025. For those sessions highlighting data insights through advanced analytics, the necessity of quality data is undeniable. Multiple speakers pointed out that maintaining a competitive advantage depends on proactive planning supported by sophisticated … Sustaining payer success: Key themes from Becker’s Payer Issues Roundtable
New eBook: Harnessing analytics and AI: A modern guide to risk adjustment
Reliable risk adjustment processes are a critical factor in the success of value-based care, but harnessing the array of data needed to align healthcare costs and provider compensation can be a challenging undertaking. With a growing number of patients enrolled in VBC programs, including the more than 33 million patients enrolled in Medicare Advantage (MA), … New eBook: Harnessing analytics and AI: A modern guide to risk adjustment
Navigating value-based care in 2025: How to implement it successfully in your practice
The healthcare industry is changing rapidly, influenced by new regulations, higher consumer expectations, and increasing cost pressures. In addition, the Centers for Medicare & Medicaid Services (CMS) has a big goal: by 2030, all Medicare beneficiaries should be in value-based care (VBC) arrangements. This means we’re seeing a fast shift away from the traditional fee-for-service … Navigating value-based care in 2025: How to implement it successfully in your practice
Top 3 takeaways from NAACOS Spring 2025 Conference
The NAACOS Spring Conference 2025, held April 22-24 in Baltimore, brought together a dynamic mix of healthcare professionals, policymakers, and innovators, dedicated to shaping the future of Accountable Care Organizations (ACOs). This year’s event underscored the need for health systems to address evolving challenges and advance value-based care (VBC) to enhance care quality, improve patient … Top 3 takeaways from NAACOS Spring 2025 Conference
