Value-Based Care Insights

Medicare Advantage (MA) continues to grow and reshape the healthcare landscape, with CMS projecting that 34 million people, approximately 47.4% of Medicare beneficiaries, will be enrolled in MA plans in 2027. At the same time, financial pressures, rising denial rates, administrative complexity, and changing risk models are creating new challenges for health plans and providers alike. In this episo...

Care management is often viewed as one component of value-based care. But what if it is actually the engine that drives the entire model? In this episode of Value-Based Care Insights, Daniel Marino sits down with Patty Resnik, a healthcare executive with deep experience in care management, population health, quality, and value-based care, to explore what it takes to build a high-performing and fin...

As CMS continues to refine its approach to value-based care, healthcare organizations face critical decisions about how to participate in accountable care models. With ACO REACH coming to an end and new opportunities emerging through LEAD and the evolving Medicare Shared Savings Program (MSSP), 2027 marks an important inflection point for providers. In this episode of Value-Based Care Insights, Da...

Healthcare organizations are under increasing pressure to improve access while balancing patient expectations, provider capacity, and operational complexity. In this episode of Value-Based Care Insights, Daniel Marino is joined by healthcare access leaders Jon Fullerton and Jenny Hart to discuss what it takes to create a more coordinated and sustainable access strategy. The discussion highlights r...

As healthcare organizations advance value-based care strategies, clinically integrated networks remain a key vehicle for aligning physicians, improving performance, and building the infrastructure needed to succeed under new payment models. But sustaining a high-performing CIN requires more than contracting activity; it takes clear governance, physician engagement, and a shared commitment to measu...

While value-based care has gained significant traction in adult medicine, pediatric care has often been left out of the conversation. Yet investing in children's health may be one of the most effective ways to improve long-term outcomes, strengthen communities, and reduce the total cost of care. In this episode of Value-Based Care Insights, Daniel Marino welcomes Dr. Suzanne Brixey, Executive...

The conversations at this year's HFMA Annual Conference made one thing clear: value-based care is no longer just about reimbursement; it's becoming the foundation for how healthcare organizations operate. In this episode of Value-Based Care Insights, Daniel Marino is joined by Katie Gilfillan, Director of Healthcare Finance Policy at HFMA, to discuss four themes from the conference: the tr...

Medicare Advantage enrollment continues to grow, but for many health systems, the administrative burden, prior authorization requirements, delayed care, and financial pressures are prompting leaders to reassess whether these plans continue to support their mission and patients. In this episode of Value-Based Care Insights, Daniel Marino sits down with Ivan Mitchell, CEO of Great Plains Health, to...

As hospitals face increasing financial pressures, workforce shortages, and growing demands for surgical efficiency, perioperative performance has never been more critical. Yet one of the most overlooked drivers of success may be sitting right in the operating room. In this episode of Value-Based Care Insights, Daniel Marino is joined by Dr. Angel Martino-Horrall, anesthesiologist, consultant, and...

Emergency department overcrowding has become one of healthcare's most pressing operational challenges, yet many organizations continue to focus on symptoms rather than underlying causes. As patient acuity rises and hospital capacity constraints intensify, emergency departments are increasingly serving as the front door to complex care delivery. In this episode of Value-Based Care Insights, Dan...

In this episode of Value Based Care Insights, host Daniel Marino is joined by ECG’s Amanda Adams and Jessica Wells to discuss key themes and takeaways from the Becker’s Healthcare 16th Annual Meeting in Chicago. Together, they explore how healthcare organizations are rethinking workforce development, physician leadership, and operational integration amid growing financial, regulatory, and staffing...

As healthcare organizations continue to expand their employed provider networks, physician compensation design is becoming far more complex and far more strategic than simply measuring productivity through work RVUs. Today’s healthcare employers must think differently about how compensation models support organizational performance, physician engagement, retention, and value-based care objectives....

As healthcare continues to evolve, conversations from HIMSS 2026 offer a clear glimpse into what’s ahead. In this episode of Value-Based Care Insights, host Daniel Marino is joined by healthcare strategist and The AI Shift host Tom Foley to unpack the conference’s biggest themes. Together, they explore how artificial intelligence (AI) is advancing into real clinical use, the persistent challenges...

As financial pressures intensify across healthcare, payers are rethinking traditional strategies and accelerating their transition to value-based care. In this episode of Value-Based Care Insights, host Daniel Marino speaks with Joe Mangrum, Partner at ECG Management Consultants, about how payers are adapting to rising medical costs, tightening Medicare Advantage margins, and increasing regulatory...

As the CMS Transforming Episode Accountability Model (TEAM) launched on January 1, 2026, healthcare organizations are now facing the realities of implementation and the pressure to perform. In this episode of Value Based Care Insights, host Daniel Marino speaks with healthcare strategist Heather Flynn Kearney about what organizations are experiencing during the early stages of this mandatory model...

As Medicare Advantage enrollment continues to rise, health systems and provider organizations are recognizing that these contracts demand more than traditional care delivery. In this episode of Value-Based Care Insights, host Daniel Marino is joined by value-based care expert Dr. Doug Ardoin to examine what drives performance in Medicare Advantage. Together, they discuss why provider organizations...

In this special episode of Value-Based Care Insights, host Daniel Marino announces an exciting new chapter: Lumina Health Partners has joined ECG Management Consultants. Dan is joined by Terri Welter, Partner and Leader of ECG’s Payer Strategy and Contracting Division. Together, they explore the evolving dynamics between payers and providers, the growing role of advanced analytics and transparency...

Emergency departments are under more pressure than ever as they are facing overcrowding, extended wait times, workforce strain, and rising patient demand fueled in part by primary care shortages. In this episode of Value-Based Care Insights, host Daniel Marino examines how these mounting challenges are reshaping the hospital’s front door and what they mean for patient care, operational performance...

As healthcare organizations move from AI curiosity to real-world implementation, many leaders are asking the same question: where do we actually begin? As the industry heads into 2026, providers are under pressure to move beyond experimentation and apply artificial intelligence in ways that deliver meaningful, workflow-driven impact without adding technology overload. In this episode of Value-Base...

Artificial intelligence (AI) is rapidly reshaping healthcare, yet many provider organizations still struggle to move from interest to practical application particularly when it comes to value-based care contracts. While AI promises efficiency and insight, turning it into measurable performance and financial advantage remains a challenge. In this episode of Value-Based Care Insights, host Daniel Ma...

As healthcare leaders look ahead to 2026, the pace of change shows no signs of slowing. From the rapid acceleration of artificial intelligence and evolving site-of-service regulations to new federal policy signals and leadership shifts in Washington, the strategic pressures facing providers, including hospitals and medical groups, are intensifying. In this episode of Value-Based Care Insights, hos...

Orthopedic care is evolving rapidly, driven by shifts in site-of-service, advances in surgical techniques, and growing patient expectations for advanced technology, improved outcomes, and convenience. As procedures, such as joint replacements, move from inpatient settings to same-day outpatient care, orthopedic groups are rethinking how they deliver high-quality, cost-effective care while remainin...

As the year comes to a close, we thought you would enjoy a throwback to one of our most popular episodes of 2025. In this episode of Value-Based Care Insights, host Daniel Marino explores the evolving role of artificial intelligence (AI) in population health. As AI continues to dominate industry conversations and drive vendor offerings, healthcare leaders are faced with questions: What is real, wh...

Cardiovascular service lines are in the midst of a major transformation, reshaping how physicians and health systems deliver care. Sites of service are shifting, patients present with greater complexity, and prevention is taking on a more prominent role across the continuum of care. In this episode of Value-Based Care Insights, host Daniel Marino is joined by longtime colleague and nationally reco...

Strengthening service line performance requires a strong foundation in primary care, which remains central to delivering effective value-based care. Yet, the landscape of primary care delivery is marked by significant challenges including workforce shortages, provider burnout, administrative burdens, and increasing barriers to patient access. In this episode of Value-Based Care Insights, host Dani...