Healthmonix

What if your doctor got paid for your blood pressure actually coming down, not just for the office visit?

That's the idea behind ACCESS, Medicare's new outcomes-based care model launching this July. It's a decade-long bet that paying for results, not activity, can change how chronic illness gets treated in America.

We broke it down in plain language on the Healthmonix blog. Worth a read if you work in healthcare or just want to understand where the system is heading. 👇

What if Medicare paid for results, not visits? What if Medicare paid for results, not visits? The ACCESS model is a new ten-year federal experiment that pays for patient outcomes — not activity. Here's what it means for chronic care in America.

The riskiest AI in your organization isn't the tool you vetted and purchased.

It's the one your clinicians are already using on their own, right now.

2 in 3 physicians use AI daily. Most of it operates completely outside governance, on personal accounts, with no audit trail.

Our latest piece breaks down what's really happening at the leading edge of healthcare AI and what health systems, physician groups, and FQHCs need to do before the gap gets any wider.

Read it here →

Beneath the waterline — Healthcare's shift to AI Agentic AI is already reshaping healthcare operations. See what leading health systems are doing differently — and what governance gaps most organizations still face.

Most value-based care strategies are built around primary care.

That made sense ten years ago. It doesn't anymore.

Specialists manage or influence roughly 80% of total cost of care. And yet the typical ACO's toolkit: gap lists, panel management, HCC coding, touches almost none of it.

CMS has noticed. TEAM is now mandatory for ~700 hospitals. CJR X expands episodic risk to essentially all hospitals in the country. Every new model pulls specialists further into accountability, whether organizations are ready or not.

There's a better framework. And there are organizations already using it to generate seven-figure value from a single surgeon's practice.

Read the full blog -> https://blog.healthmonix.com/the-80-percent-problem-why-value-based-care-will-be-won-in-specialty

The 80% problem: Why value-based care will be won in specialty Specialists drive 80% of healthcare costs, yet most value-based care strategies ignore them. Learn how to close the gap before CMS makes it mandatory.

We got back AMGA 2026 and one question keeps coming back to us.

Can your team actually see where you're failing in value-based care before it's too late to fix it? Not in a year-end report, but in real time, across every payer.

Most health systems can't, and that gap costs $2M to $8M a year.

We broke down why in our latest Field Notes, including what we heard in Las Vegas and what it means for 2027.

Read it here: https://blog.healthmonix.com/the-vbc-bottleneck-has-changed

The VBC Bottleneck Has Changed Value-based care's real bottleneck is measurement infrastructure — costing health systems $2–8M annually. What AMGA 2026 made impossible to ignore.

Happening this Wednesday: Healthcare executives are facing a rapidly evolving value-based care landscape. Join Healthmonix for Building your 2026 value-based care strategy webinar to learn how to align quality performance, cost of care, and organizational readiness for the year ahead.

📅 Wednesday, May 20
🕐 1 p.m. ET

Reserve your spot today: https://hubs.li/Q04gHRzf0

Can’t make it to the live webinar? Register to receive a free recording of the webinar and slides.

20% of NPPES records change every year. Only 28% match payer directories. That’s the foundation for MIPS attribution and ACO enrollment today.

CMS’ new National Provider Directory won’t replace NPPES, but it adds what NPPES can’t: real affiliations, FHIR endpoints, and near real-time updates.

Inside our solution, Prism™, we’re ingesting both. Teams that see this shift early gain a structural advantage. Others will still be reconciling NPI data years from now.

👉 Read the full breakdown: https://blog.healthmonix.com/nppes-vs.-cms-national-provider-directory

NPPES vs. CMS National Provider Directory Is the CMS National Provider Directory replacing NPPES? No — NPPES remains the source of truth for MIPS and attribution in 2026. NPD is a new FHIR layer.

A strong value-based care strategy starts with understanding what’s changing, and how your organization can prepare.

In our upcoming webinar, building your 2026 value-based care strategy, we’ll discuss key considerations for program planning, quality performance, cost visibility, and regulatory uncertainty.

📅 Wednesday, May 20
🕐 1 p.m. ET

Register today, you don't want to miss this! https://hubs.li/Q04gFd0V0.

Can’t make it to the live webinar? Register to receive a free recording of the webinar and slides.

Attending the TXAACOs Conference this week and impressed by the strength of the agenda. A clear focus on tech stack rationalization and the practical application of AI in healthcare—two areas that are rapidly shaping how organizations operate and deliver value.

Equally valuable is the opportunity to connect with forward-thinking healthcare leaders who are tackling many of the same challenges and opportunities. Looking forward to the conversations, insights, and ideas that come out of this."

2026 is bringing new complexity to value-based care. The question is, are you prepared?

Join our upcoming webinar to learn how to evaluate your current programs, turn quality data into strategy, and plan for regulatory uncertainty.

Wednesday, May 20 | 1 pm ET
Live Q&A included

Register now to reserve your spot: https://hubs.li/Q04fhmBG0

We're heading to NAACOS Spring 2026! 🎉

Find the Healthmonix team at Booth 28 (April 22–24) to talk value-based care performance, MIPS reporting, and how Prism is helping ACOs navigate today's shifting policy landscape.

If you're attending, let's connect — drop a comment or click the link to schedule a meeting at the booth! https://hubs.li/Q04c8blX0