VBC-Ready AI: 10 Criteria for Investor-Grade Health Platforms
The promise of AI in healthcare often collides with the rigorous demands of value-based care (VBC). For health plan executives and investors navigating this complex…
Unlocking Virtual Care: The Economic Engine of Federal Billing Codes
The field of virtual care, once a patchwork of emergent technologies and uncertain reimbursement, has found a more stable footing thanks to specific federal billing…
CMS Star Ratings Shift: The New ROI for Digital Health Platforms
Medicare Advantage (MA) plans operate within a complex financial ecosystem, where quality ratings directly translate into billions of dollars in bonus payments. For plan executives…
Medicare Advantage RPM: Unpacking the Actuarial ROI Reality
The promise of remote patient monitoring (RPM) in value-based care (VBC) arrangements often conjures images of significant cost savings and improved patient outcomes. Yet, for…
Federal PA Rules: Unlocking Billions in Automated UM Platforms
The healthcare field is undergoing a seismic shift, driven by regulatory pressures aimed at alleviating administrative burden and enhancing interoperability. For investors in digital health…
CMS Interoperability Rule: Billion-Dollar Impact on Health Tech
The Centers for Medicare & Medicaid Services (CMS) have, with the release of the Interoperability and Prior Authorization Final Rule (CMS-0057-F), irrevocably reshaped the operational…
Unlocking Value-Based Oncology: Bridging Data Gaps
Transitioning oncology to value-based care (VBC) models presents a formidable challenge, primarily due to the high costs associated with novel therapies and the inherent complexity…
MSK ROI: De-Risking Digital Health Investments for Employers
Digital musculoskeletal (MSK) programs have proliferated, promising significant relief for a major category of employer health spend. Yet, the financial claims associated with these solutions…
Actuarial Drivers: Unlocking Multi-Year RPM Savings for Investors
The field of value-based care is rapidly evolving, and with it, the scrutiny applied to the economic claims of digital health platforms. Short-term pilot programs,…
ACO REACH: Unlocking Digital Health ROI for Investors
The Centers for Medicare & Medicaid Services (CMS) ACO REACH model is fundamentally reshaping the risk-sharing dynamics within primary care, compelling providers to adopt more…