Care Management
Expert articles and analysis related to care management.
AI Summary — Last 30 Days
Care management is becoming the operational core of VBC performance, with providers and specialty enablement companies moving from retrospective quality reporting toward embedded, data-driven workflows: TPMG’s 12-year primary care journey shows independent practices using EHR optimization, automated outreach, and care management billing to make VBC financially viable, while Prisma Health is pushing care managers, transitions nurses, ED navigators, pharmacists, behavioral health managers, and social workers into frontline “Care Team Pods” tied to real-time population health data. Specialty models are also scaling around earlier identification and longitudinal coordination—Strive Health’s kidney care model, Interwell’s CKCC results, Synapticure’s GUIDE dementia positioning, and oncology ePRO use cases all point to a broader shift from episodic disease management to condition-specific care platforms aligned with Medicare value-based models. For ACOs, payers, and health systems, the strategic tension is no longer whether care management matters, but whether they can fund, staff, and automate it fast enough to capture shared savings and model-specific revenue before specialty carve-outs and AI-enabled entrants control the highest-risk populations (TPMG VBC operating model; Prisma Health care strategy).
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