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Industry expert David Smith, Founder and CEO of Third Horizon Strategies, provides an overview of CMS’s value-based initiatives with specific perspectives on the new administration’s Medicare/Medicaid philosophy, the rise of complex care management, and Medicaid Advanced Payment Models. He also shares an update on the core CMS payment models including MIPS, ACOs, and BPCI, as well as the newly announced direct contracting initiative. With his keen political awareness and relationships, David offers his predictive roadmap for these programs and other initiatives by the Center for Medicare & Medicaid Innovation.
Medical Economics| May 12, 2021

Each year, a growing number of providers are entering value-based care arrangements, including primary care providers (PCPs). Given their holistic view of patients, PCPs are the best types of clinicians to drive value-based care. Medicare’s Primary Care Transformation programs and many payer-developed value-based care contracts are proof of the move for PCPs to be at the center of this transformation and ultimately at the center of the care experience — right where they belong.
Population Health Learning Network | May 17, 2021
The move to value-based care—where payment for volume of services is being supplanted by payment for outcomes of care—has proceeded with remarkable speed since the Affordable Care Act (ACA) went into law a mere ten years ago. Payment for outcomes increasingly focuses on holding providers of healthcare responsible for total costs of care. Accountable Care Organizations (ACOs) began in 2014 under the direction of the Centers for Medicare and Medicaid Services’ (CMS) Shared Savings Program (MSSP).
Throughout the Coronavirus pandemic, several innovative data tracking tools have been identified to support population-based public health and individual patient level care management. Some of these are less traditional ways to look at health data, and can usefully inform health planning and system of care design strategies. A curious question is, can we use these novel health data approaches to better inform the care management process? A brief review of some of the recent health tracking tools and approaches provides insights for new ways to think about care management throughout the current pandemic and beyond.
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Upcoming Conferences
11th National ACO Summit
September 20-23, 2021 (Virtual)

American Physician Groups Annual Conference
December 9-11, 2021 | San Diego, CA

Exhibitor Spotlight
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Platinum Level Exhibitors
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Gold Level Exhibitors
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