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.

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.

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.

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