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This week I attended the House Care 100 occasion in Phoenix, Arizona.

From panels to my interviews to hallway conversations, the brand new fashions popping out of the Facilities for Medicare & Medicaid Providers (CMS) Innovation Middle had been a frequent subject of debate. These fashions are particularly essential as non-public sector payers develop into more and more reluctant to innovate, stated Devin Woodley, vp of managed care contracting at VNS Well being.

“They wish to see a a lot increased return on their investments, and… it actually simply means price financial savings,” Woodley stated. “They’re eliminating numerous the value-based applications. On the identical time, we’re seeing much more innovation on the CMS facet. So CMMI is rolling out extra fashions.

“We’re really seeing a serious shift within the paradigm of the place innovation comes from,” he continued. “It is the other of what it was a number of years in the past.”

The opposite paradigm shift that frequently caught my consideration all through the convention was round know-how. Instruments that might remodel the trade could at the moment be too area of interest, too remoted and too troublesome to check. However the trade is at a precipice the place these issues can be overcome, and new know-how will make day by day operations fully unrecognizable.

These two adjustments not solely dominated my conversations on the occasion; they may dominate how the sector delivers and will get paid for healthcare for the foreseeable future.

On this week’s HHCN+ Replace, I share my key insights from my expertise on the occasion, together with:

– The reimbursement fashions which have attracted the eye of suppliers

– The know-how on the lips of suppliers

– Why uncertainty controls innovation

CMMI fashions

Introduced in Might 2025, CMS’ Innovation Middle technique features a deal with giving sufferers the chance to decide on their well being care path, together with the selection to obtain care at dwelling.

As a part of this motion and the group’s current work to maneuver away from the established order of paying for companies, extra fashions that target dwelling care have emerged.

“Most likely everybody” who was at House Care 100 is evaluating the ACCESS mannequin, Woodley stated. This voluntary mannequin, which stands for Advancing Persistent Care with Efficient, Scalable Options, consists of an outcomes-based cost mannequin with technology-enabled care fashions. The mannequin has been praised by advocacy group ATA Motion and presents sufferers an thrilling technique to obtain care exterior of conventional places – however it isn’t but absolutely understood by the trade.

“I have never spoken to anybody who actually appears like they’ve wrapped their arms round ACCESS and perceive it precisely [what] the mannequin is and how one can ship it,” Woodley stated.[At] a really excessive stage, it feels to me like longitudinal care administration. That is nice as a result of … we already do superior care planning in power care administration codes for the unique Medicare inhabitants, however that is now the place we will go deeper with that membership, and if we will do it in a PMPM area, now you may also work with them on a extra constant foundation. And I really feel like there’s numerous profit in that.”

I’ve plans to delve deeper into the ACCESS mannequin, nevertheless it’s thrilling to see an rising mannequin beginning to acquire a foothold in suppliers’ methods.

The convention additionally talked about the obligatory bundled Remodeling Episode Accountability Mannequin (TEAM), which went into impact on January 1, and the ACO REACH (Accountable Care Group Realizing Fairness, Entry, and Group Well being) program, which can be adopted by the Lengthy-term Enhanced ACO Design (LEAD) Mannequin after ACO REACH expires on the finish of this 12 months.

These fashions are essential to facilitating the trade’s transition away from the fact of fee-for-service – and so they display Woodley’s level about the place innovation will come from. Suppliers who’re stagnant in value-based conversations with payers ought to welcome the voluntary fashions with open arms and search to maximise their expertise with the obligatory fashions as they appear to catapult their firms into the subsequent period of dwelling care.

Nonetheless, an vital takeaway is how a lot uncertainty is swirling round these fashions, given the shortage of readability round ACCESS, the brand new launch of TEAM, and the still-impending transition from REACH to LEAD. Below the Trump administration, CMS doesn’t have an awesome observe document on communications (contemplate the suspension of exterior HHS communications a few 12 months in the past). Suppliers could wrestle to efficiently put together for and take part in these new cost fashions until they acquire extra readability on these frameworks. As well as, some suppliers – together with hospice and residential care supplier By the Bay Well being – have withdrawn from CMS’ Guiding an Enhanced Dementia Expertise (GUIDE) program. After preliminary pleasure, By the Bay decided that the monetary math wasn’t working for the group, and GUIDE appeared “sloppy and undefined” when thought-about alongside By the Bay’s current PACE providing.

So whereas it was thrilling to listen to upbeat speak concerning the newest CMS cost fashions, I hope the company works productively with suppliers to make these fashions profitable – and that I do not hear a very completely different tune at House Care 100 subsequent 12 months.

Know-how disruptors

In off-the-record chats with supplier executives, the dialog typically turns to know-how suggestions. Everybody desires to know who makes use of what know-how. Who did they exit to dinner with? How area of interest of an issue is just too area of interest to spend money on a technical resolution? Does this and that AI resolution combine nicely with a selected EHR?

This was definitely the case at House Care 100. It helped that the occasion was themed across the function of information, highlighting the necessity for healthcare suppliers to acquire, analyze and leverage key information factors within the pursuit of improved high quality and extra favorable reimbursement agreements. With the necessity for information typically additionally comes the necessity for know-how that may gather and analyze information.

Extra attention-grabbing than the know-how that sifts by means of information, nevertheless, had been the instruments that improved effectivity, high quality and the expertise of caregivers and shoppers. Know-how equivalent to distant affected person monitoring instruments for particular buyer populations, specialised transcription companies and different back-end instruments had been all prime priorities.

Whereas suppliers are enthusiastic about integrating these instruments into their tech stacks, the issue I extrapolated from my conversations is that there are a staggering variety of instruments that tackle such a variety of issues.

Simply because the iPhone disrupted the reigns of the Blackberry and the Motorola Razr that I all the time wished however by no means acquired, I count on a few of these under-the-radar instruments would be the ones that change the way in which carriers function – nevertheless it’s troublesome for me, and for service executives, to find out which know-how will win the market, very like the iPhone that eclipsed different smartphone fashions.

What ties my two key insights collectively is the fact that the house care trade is raring to embrace innovation, whereas on the identical time uncertainty limits suppliers. I imagine it’s inevitable that value-based and managed care fashions will proceed to redefine how healthcare suppliers are paid, and that AI and different transformative applied sciences can be extensively adopted and reinvent key components of operations and even medical supply. So suppliers should do their greatest to learn the indicators and make good selections about which fashions and know-how to spend money on, whereas on the identical time remaining (or changing into) agile to pivot as essential as they acquire extra readability about which experiments and improvements show to be probably the most sustainable.