The advancement of value-based care cannot and should not exist solely in a payvider model, Intermountain Health CEO Rob Allen argued in an interview last week. Having its own health plan made things “a little easier” when Intermountain began getting serious about at-risk contracts, but achieving success in value-based care “is more about your commitment to the approach” and forging strong relationships with payers of all types.

As value-based care models take hold, the time is ripe for rehab therapists to position themselves as primary players in the movement toward delivering optimal quality and value in the broader healthcare ecosystem.

The commercial market has struggled to adopt value-based care, but HealthPartners has had some success, according to Mark Hansberry, senior vice president and chief marketing officer of the company. During a conference, he shared five rules for scaling value-based care, including creating trust and providing real-time data.

For the gridlock in mental healthcare to be resolved, 100% of mental healthcare providers must practice measurement-based care, utilizing validated rating scales to monitor and measure longitudinal outcomes for every patient. And payers then must offer reimbursement that appropriately rewards providers for delivering high-quality, effective care, and incentivize proactive mental health management.

CardioOne, a startup built at Redesign Health, partners with independent cardiology practices to help them transition to value-based care. On Monday, the company announced it has raised $8 million in seed funding and has three new partners.

Through a new partnership with Walgreens, Pearl Health will work with primary care providers by offering its technology and data insights to help them better their care and transition to value-based payment models. Walgreens is then providing prescription fulfillment, medication adherence, immunization and diagnostic testing services.

The Centers for Medicare and Medicaid Services has announced two value-based care alternative payment models set to launch in July 2024, one focused on dementia and one on primary care.

As the value-based care market gets more crowded, startups in this space will have to nail down the fundamentals in order to attract capital from investors, healthcare business expert Paul Campbell said during a virtual conference. He encouraged startups to be crystal clear about what their value proposition is for three main stakeholders — patients, providers and payers.

Through a new partnership, Castell will be able to refer members of its Utah health plan customers to Headspace for behavioral health coaching and therapy.

Although many employers and consumers don’t understand the difference between value-based care and fee-for-service, most are in favor of value-based care after being given the definition, a new survey found.

For the sixth year in a row, the Medicare Shared Savings Program created overall savings, CMS announced. When compared to clinician groups of a similar size not participating in the program, participating ACOs performed better on quality measures, including measures for diabetes, breast cancer and colorectal cancer screenings, tobacco screenings and depression screenings.

Fee-for-services payment models in the primary care ecosystem are doing a poor job of keeping Americans healthy and reducing the nation’s massive amount of healthcare spending, two CEOs of primary care companies said during a recent webinar. They argued that stakeholders in the primary care space need to come together to support more value-based care arrangements to reduce costs, advance population health and improve the patient experience.

CMS’ Enhancing Oncology Model and Cancer Moonshot are the forcing functions to achieve value-based care in oncology. In the spirit of working together to improve lives, this is a MUST for physicians to consider–before they get left behind.

While greater operational efficiency and cost control are essential to the success of VBC initiatives, so too is patient engagement. Care coordination and care management are far more difficult – and far less likely to achieve optimal outcomes – without patients who are fully engaged with their providers.

This week, virtual care company Babylon Health permanently closed its U.S. operations and laid off 94 employees. The news came after the company’s rescue merger fell apart — Babylon had planned to go private through a deal with Swiss digital therapeutics firm MindMaze and Babylon creditor AlbaCore Capital.

M&A activity in the healthcare sector continued to decline in the second quarter of 2023, with the number of deals reaching its lowest point in three years. However, a new report predicted that M&A activity could increase in the second half of this year due to healthcare companies’ continually shrinking valuations and their divestitures of non-core assets.

Even as value-based care finds its footing and expands further, team-based approaches to care delivery incorporating pharmacists as crucial connections are already bearing results—helping provider organizations achieve 5-star CMS ratings for medication adherence, driving down costs, and driving up the quality of life for patients.

The traditional transactional approach to the coding of diagnoses to support billing in a fee-for-service environment is not adequate to meet the care requirements of VBC programs.

Aledade’s $260 million financing round was led by Lightspeed Venture Partners, a new investor of the company. It also included participation from Venrock, Avidity Partners, OMERS Growth Equity and Fidelity Management and Research Company.

The Making Care Primary Model will be tested by the Center for Medicare and Medicaid Innovation from July 1, 2024, to December 31, 2034, in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina and Washington.

Syntax Health’s new two-sided software-as-a-service solution allows payers and providers (as well as actuaries, network managers and analysts) to collaborate in creating a value-based contract.

Upperline Health, a provider network focused on value-based specialty care, recently raised $58 million. The startup identifies patients who are seeing specialists four or more times a year and provides them with an interdisciplinary care team that treats them at a clinic, in their home or via phone.

Yuvo Health — a startup focused on enabling value-based care at FQHCs — recently raised $20.2 million in Series A funding. The company is using the money to expand its reach from New York to Ohio.

Healthcare IT companies experienced a bounceback in venture capital deal activity during Q1 of 2023. Rebecca Springer, PitchBook ’s lead healthcare analyst, said she is optimistic that healthcare IT startups will be able to keep this momentum going, especially those focused on staffing and value-based care enablement.

Strive Health’s $166 million funding round was led by NEA and included participation from CVS Health Ventures, CapitalG, Echo Health Ventures, Town Hall Ventures, Ascension Ventures and Redpoint. In total, the company has raised more than $400 million.

Experts argued that value-based care is here to stay and will play a major role in the future of healthcare during MedCity’s Invest conference in Chicago. A panel of four agreed that the success of value-based care depends on organizational commitment — it’s a quixotic mistake to think these alternative payment models can gain traction overnight.

Absent the ability to bolster their ranks with more clinicians, what rural health centers need first and foremost to shift to value are technologies that amplify their clinical capacity without further burdening and burning out their core staff.

Kaiser Permanente announced that it expects to acquire Pennsylvania-based Geisinger Health. Kaiser’s move is part of a larger plan — Geisinger will be the first health system to join Risant Health, a new company Kaiser launched to operate nonprofit health systems under value-based care models. Kaiser said it expects to invest $5 billion in Risant and fold five or six health systems into the company over the next five years.

MedCity News connected with Global Health Leader at EY, Aloha McBride, to share details on the company’s upcoming survey on what consumers are looking for in value-based care.

A shift from fee-for-service payment models to value-based models is not an effective way to address the severe financial pressures that safety net hospitals are facing, experts argued at the HIMSS conference in Chicago. One called for a paradigmatic shift “away from cost savings and toward understanding where investments are needed.”