Value-Based Care| VBC-Related News, Analysis, Insights - HIT Consultant

What You Should Know Blue Cross Blue Shield of Massachusetts ("Blue Cross") has formalized its first-ever specialty-specific, outcomes-based value-based contract by partnering with cancer care orchestration innovator Thyme Care.The risk-bearing model shifts oncology reimbursement metrics entirely away from traditional, volume-driven fee-for-service loops to prioritize reimbursement tied directly to patient health outcomes.While this marks the plan's first specialized oncology venture, Blue
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Population Health Has a Precision Problem Population health programs continue to rely on blunt tools. Many risk stratification approaches emphasize historical utilization—basic risk scores or vendor-generated models that explain who was expensive—rather than identifying emerging clinical risk. These methods struggle to detect deterioration early enough to influence outcomes. At the same time, care management teams face persistent resource constraints. Organizations cannot provide intensive
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What You Should Know The Funding: Greater Good Health has secured a $20.5M Series B led by Allumia Ventures, alongside up to $12.5M in venture debt from HSBC Innovation Banking.The Backers: The round features strategic participation from heavy hitters, including DaVita Venture Group, Granite Financial Holdings (the investment arm of Blue Cross of Idaho), Optum Ventures, and Flare Capital Partners.The Model: The company tackles the primary care physician shortage by deploying a Nurse
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What You Should Know The Affordability Crisis: According to the newly released 2026 Physician Sentiment Survey from athenahealth’s research hub, athenaInstitute, access to affordable healthcare has surged to become the #1 policy concern among physicians (52%, up a massive 14 points over the last three years), indicating that patient financial strain is now directly impacting clinical delivery.The Technology Paradox: While overall optimism about the U.S. healthcare system remains stagnant at
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What You Should Know The Funding: Honest Health raises $140M led by NewSpring Healthcare, with participation from K2 HealthVentures, Rubicon Founders, Oak HC/FT, and others.The Mission: The company provides the technology-enabled care coordination, data analytics, and operational infrastructure required for legacy health systems and providers to succeed in value-based care (VBC) and shared-risk payment models.The Pedigree: Honest Health boasts heavy-hitting leadership. CEO Dr. Rob Bessler
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MIPS (Merit-based Incentive Payment System), a Medicare program that rewards clinicians for delivering high-quality, cost-efficient care, is by nature an evolving entity.  Much the way healthcare continually changes as new knowledge, treatments, and technologies modify past practices, MIPS is ever-changing, with program updates, revisions, and new requirements.  While these changes are well-intentioned and support value-based healthcare, they don’t necessarily make it easier for
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As the Centers for Medicare & Medicaid Services moves forward with the Transforming Episode Accountability Model (TEAM), hospitals are taking on financial accountability for Medicare’s most complex and costly surgical episodes. Hospitals that don’t take action to achieve better patient outcomes could find themselves owing Medicare money.   While TEAM shifts meaningful risk to hospitals, it also creates an opportunity often missing in value-based care: true collaboration with
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What You Should Know The Raise: Frist Cressey Ventures (FCV) has closed an oversubscribed $425M Fund IV, bringing its total assets under management to nearly $1 billion.The Strategy: The new fund will focus on early-stage healthcare companies transforming care delivery, with a specific emphasis on AI-native business models and tech-enabled services.The "Moat": FCV’s strategic Limited Partners (LPs)—including The Cigna Group, MedStar Health, and OhioHealth—provide healthcare to over 50% of the
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What You Should Know The Raise: Atlas Oncology Partners has closed a $28M Series A financing round led by Flare Capital Partners, with significant backing from Rubicon Founders.The Model: Atlas isn't just a software vendor; it is a value-based care platform that assumes full medical cost risk. This means they are financially responsible for the total cost of a patient's cancer journey, aligning their incentives with payers and patients.The Strategy: The company embeds interdisciplinary care
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As healthcare costs continue to increase and patients demand more from their insurance coverage, there’s rising pressure to provide higher-quality care more efficiently than ever before. The expectations for healthcare payers to achieve the Triple Aim objectives—that is, better patient experiences and improved population health at lower costs—demand that we all become more resourceful in our approach to care. It's clear that health plans and hospital systems can’t achieve these ambitious
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