Do you have confidence in your ACO’s ability to meet APP Quality Reporting requirements? The 2025 Performance Year is the first year ACOs are required to report through the APM Performance Pathway (APP). Your ACO must transition to a proven technology-based solution to be successful. You need to be well along the path to successful […]
The 2026 CMS PFS Final Rule: The 5 Ways CMS Aims to Control Total Cost of Care
The CMS PFS Final Rule is out . . . early? If you’re wondering how, in the midst of the Shutdown, a 2,375-page Rule could be released, the answer is simple: most of the proposals from this summer were finalized as is. There are always exceptions, but the big takeaway is that this Rule solidifies […]
Three Strategies for ACOs to Optimize Specialty Care through TEAM
Both the greatest strength and weakness of the ACO shared savings (MSSP) model is its focus on primary care, particularly chronic disease. ACOs have put patients with diabetes, hypertension, and other conditions usually handled through primary care physicians at the center of care coordination, population health, and care management. But as CMS Value-Based Care’s central […]
Providers: Collaborate or Lose Under TEAM Risk-Based Payment for Specialty Procedures
Surgery will be a financial winner or loser under TEAM (Transforming Episode Accountability Model), a mandatory episodic payment model beginning in January 2026. Let’s be clear: TEAM requires a tectonic plate shift in managing cost and outcomes of surgical procedures for five types of procedures. To be on the winning side of this model, your […]
CMS is Demanding Change in Specialty Care: 5 Things to Know about ASM
Heads up! CMS’s Proposed 2026 PFS Rule introduces a new payment model for tackling specialty care and costs in traditional Medicare. Clearly not a snap decision, Ambulatory Specialty Model (ASM) has been cooked until well-seasoned and served up in 210 pages of the proposed Rule. Unlike a typical Notice from the CMS Innovation Center that […]
CMS Commits to Control Total Cost of Care: 6 Volleys in the 2026 CMS PFS Proposed Rule
Summer is here, and the heat is on: barbeques, beaches, and the 2026 CMS Physician Fee Schedule Proposed Rule. Throughout 1,803 pages, CMS is going after the total cost of care in the MIPS and APM tracks of the Quality Payment Program (QPP). These proposed updates and the creation of a surprise new (and mandatory!) […]
Roji Health Intelligence Response to CMS RFI for Health Technology Ecosystem
Data and technology, once simply functional assets to facilitate health care, are now a leading force for health care advancement, improvement of health care outcomes, and control of costs. Yet the panoply of technologies has not optimized information for one key actor: the patient. The Center for Medicare and Medicaid Services (CMS) is attempting to […]
Let’s Put an End to What Blocks Providers and Patients from Controlling Health Care Costs
We often blame providers for not controlling health care costs. We also put the onus on patients who overuse care inappropriately and make bad choices. But the fact is that control of health care costs is extremely complicated, and we have effectively blocked both providers and patients from controlling health care costs. Since the birth […]
Roji Health Intelligence Achieves HITRUST e1 Certification Demonstrating Foundational Cybersecurity
Roji Health Intelligence LLC, a leading provider of Value-Based Care technology and services to health care providers, today announced that its Roji Clinical Data Registry, ”Roji Registry”, has earned certified status by HITRUST for foundational cybersecurity. Roji delivers services to reduce the cost of health care and improve patient health through its technology, based on […]
Multi-Payer VBC Strategy Is Essential for Cost Control, but Providers Must Get a Fair Deal
To meet its goals of controlling costs and improving patient care, Value-Based Care requires a near-universal, multi-payer strategy.