Value-Based CareOctober 1, 2026 · 5 min read
ACO REACH is ending. The LEAD model for 2027
Read the post →ACO REACH ends Dec 31, 2026. CMS's LEAD Model replaces it Jan 1, 2027 with a 10-year run, two risk options and no benchmark rebasing.
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Guides for healthcareAI, quality, and outreach.
Practical guides for practice, quality, pharmacy, and billing teams: HIPAA-compliant AI, care gaps, PDC, TCM, TCPA, and the files those jobs run on.
- Value-Based CareOctober 1, 2026Medicare Annual Wellness Visit Billing Guide (2026)Bill G0438 for a first AWV and G0439 every 12 months after: about $174 and $138 (2026 national non-facility), with no patient cost-sharing.
- Value-Based CareOctober 1, 2026Build a care gap list from an attribution fileTurn a payer attribution roster into a ranked call list: dedupe, add visits and gaps, check phones and opt-outs, then prioritize and log.
- Value-Based CareOctober 1, 2026Population Health Analytics Without a Data TeamSmall practices can answer core population health questions with EHR exports, payer files and an AI workspace covered by a BAA. Here's how.
- Value-Based CareOctober 1, 2026Risk Adjustment Year-End Checklist for Primary CareRisk adjustment diagnoses reset every January. In Q4, pull your recapture list, rank it, reach patients and get chronic conditions documented at a visit.
- Value-Based CareOctober 1, 2026TCM Billing: The 2-Business-Day Rule (99495, 99496)To bill TCM, contact the patient within 2 business days of discharge and see them within 7 or 14 days, depending on complexity.
- Value-Based CareJuly 30, 2025 · Updated October 1, 2026CCM vs APCM in 2026: which should you bill?Bill CCM when you can document monthly minutes on complex patients; bill APCM when you want a flat monthly code with no time tracking.
- Value-Based CareJuly 30, 2025 · Updated October 1, 2026One patient, one conversation for gap outreachConsolidate care gap outreach by keeping one record per patient with every open item, then covering them in one prioritized conversation.
- Value-Based CareJuly 30, 2025 · Updated October 1, 2026How to Analyze a Payer Care Gap Report With AIUpload the payer file to an AI tool covered by a BAA, map and dedupe it, then ask which patients to reach first. Here is the step-by-step.