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MSSP Performance, Info Blocking Crackdown, and WiFi Pulse Checks
September 8, 2025
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Together with
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“With the ability to override the clinical management decision making of a patient’s personal physician… health plans essentially control the quality of a large portion of the healthcare in the United States.”
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Dr. Jacob Murphy et al. on the adverse effects of prior authorization.
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CMS just dropped its 2024 performance data for the Medicare Shared Savings Program, and the debate over the program’s true effectiveness rages on despite another record year.
MSSP saved Medicare $2.4B in 2024, the eighth consecutive year of savings and the highest total since the program’s inception in 2012.
- The program generates savings by working with accountable care organizations to cut down on avoidable utilization, eliminate duplicative care, and minimize costly medical errors.
- The ACOs that effectively improve care quality and reduce total spend share in the success, and last year saw 75% of participating ACOs earn $4.1B in performance incentives, a new all-time-high.
Accountable care delivers. MSSP ACOs lifted hypertension control rates to 79.5% in 2024 (up from 77.8% in 2023), while trimming the share of patients with poor hemoglobin A1c control to 9.4% (from 9.8%).
- Low revenue ACOs (typically physician-led) continue to outperform high revenue ACOs (typically hospital-led), generating $316 in net per capita savings (vs. $175).
- Most ACOs also performed better than comparable physician groups on quality measures, such as screening for depression and creating follow-up plans (53.5% vs. 44.4%).
There’s always a catch. Although at first glance 2024 was one of MSSP’s best years to-date, it’s worth noting that total Medicare spending also reached a staggering $847B.
- That means that MSSP, the crown jewel of CMS value-based care programs that includes 476 ACOs equipped with some of the best care delivery tools in the industry, delivered an overall savings of just 0.28%.
- $2.4B is nothing to scoff at, and the program is moving the needle, but it’s nowhere near fast enough to keep pace with Medicare’s runaway growth.
The Takeaway
MSSP had a great 2024 by almost every metric, and its ACOs are the tip of the spear for CMS’s push toward value-based care. That said, it’s a long journey to lower overall Medicare spending even with $2.4B steps, and there’s still plenty of work to be done to help get there faster.
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Kennedy Community Health Finds RPM Success With Withings
When Kennedy Community Health needed a partner to support remote patient monitoring for its diverse patient population, it turned to Withings Health Solutions. See how Kennedy found success with its new program for uncontrolled hypertension using Withings’ RPM platform and connected devices, surpassing enrollment goals while unlocking better outcomes for its patients.
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Under the Hood of Navina’s AI
Navina’s AI engine harnesses over 600 proprietary algorithms to transform fragmented patient data into actionable clinical intelligence at the point of care. It’s shaped with the expertise of physicians to turn multiple data sources (EHR, HIE, claims, care gap files, etc.) into contextualized insights like suspected conditions or evidence for care gap closures – each linked back to the original source. Download the whitepaper to see examples of Navina’s AI in action.
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- Remedy Meds Acquires Thirty Madison: Direct-to-consumer GLP-1 startup Remedy Meds just gobbled up competitor Thirty Madison for $500M. Remedy Meds launched just 16 months ago and was already projected to have revenue top $450M in 2025. The goal is to combine Remedy Meds’ weight loss programs with Thirty Madison’s virtual care brands, which include Keeps (hair loss), Nurx (women’s health), and Cove (migraines). Feels like we’re about to start seeing more similar moves where capital-efficient startups acquire complementary assets to expedite the path to an IPO.
- Executive Comp vs. Performance: A juicy analysis from STAT found that top healthcare executives amassed record wealth in 2024, despite leaving a trail of disappointed shareholders. Corporate filings revealed that the CEOs at 275 of the industry’s most prominent companies brought home a combined $3.6B, or $13M on average (the median CEO made over $5.5M). The kicker is that the S&P 500 Health Care Index was up less than 1% last year, while the broader market soared 24%.
- Evernorth Invests in Shields: Cigna’s Evernorth just poured $3.5B into Shields Health Solutions, a specialty pharmacy company and former Walgreens subsidiary. The investment is straight out of the UnitedHealth playbook and ties Cigna even closer to health systems that rely on specialty pharmacies to serve patients. Specialty meds are among the fastest-growing and most expensive segments of the pharmaceutical market, and the investment was positioned as a way to help Cigna “deliver exceptional care across healthcare settings – from home to physician’s office or clinic, to hospital.”
- Information Blocking Crackdown: HHS just announced a major crackdown on health information blocking, which the press release notes “was not a priority under the Biden Administration.” HHS Secretary RFK Jr. reports that the agency is increasing resources devoted to protecting data rights, and will “take an active enforcement stance” against healthcare entities that restrict patients’ engagement in their care by blocking access to electronic health information.
- Prior Auth Harms: A systematic review of 25 studies evaluating the consequences of prior authorization reached an unsurprising conclusion: PA delays are associated with measurable patient harm. The investigation in The American Journal of Medicine found that patients with common conditions (asthma, IBD, AFib, epilepsy) who were subject to PA delays frequently experience avoidable complications resulting in ED visits, hospitalizations, or invasive procedures. The authors stress that payors’ ability to override clinical decision-making allows them to “essentially control the quality” of a large portion of U.S. healthcare.
- TigerConnect Transfer Launch: TigerConnect took the lid off a new patient coordination solution to streamline interfacility transfers. TigerConnect Transfer combines bed sourcing, transport scheduling, and communication within a single application to bridge the gap between hospitals and external agencies. The solution was designed to provide real-time visibility that eliminates manual back-and-forth with outside partners, while also giving staff a clearer picture of capacity and assets.
- WiFi Pulse Check: The days of needing a smartwatch or other wearable device to check your pulse might soon be a thing of the past after a new study out of UC Santa Cruz showed that a WiFi connection can do the trick. Researchers were able to use “Pulse-Fi” technology that leverages a standard WiFi transmitter/receiver alongside a machine learning algorithm to measure heart rate with clinical-level accuracy after just five seconds of signal processing. The strength of the WiFi signal had a significant impact on performance – tale as old as time.
- WellSpan + HATCo: WellSpan Health is deepening its partnership with General Catalyst’s HATCo and becoming its first “transformation partner” to advance AI in healthcare. The initiative will focus on three areas, including automating admin tasks, using AI to personalize treatment, and developing strategies for financial sustainability. The collaboration first kicked off in 2023 and will build on WellSpan’s previous experience working with GC portfolio companies Aidoc and Hippocratic AI to address workforce shortages.
- UH Teams Up With HealthSnap: University Hospitals launched a new HealthSnap-powered RPM program focused on enhancing care for patients with uncontrolled hypertension, a condition affecting over 30% of adults in Ohio. The program is geared toward reducing preventable hospitalizations, improving blood pressure control, and driving earlier clinical interventions by equipping care teams with continuous biometric data integrated directly into UH’s existing workflows and EHRs.
- MyChart Central Roll Out: Epic has officially begun rolling out MyChart Central, its new single-login hub that allows patients to access health records from multiple providers. MyChart Central gives patients centralized access to their MyChart portal accounts and an easier way to manage their information, such as updating their address once and pushing it across all linked organizations. Epic now plans to expand availability region by region “to ensure patients have a consistent experience” across all orgs where they receive care.
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Next Generation Ambient Tech and Agents
The ambient AI transformation is already sweeping across health systems, reducing administrative burdens and improving patient outcomes. So, what’s next? Tune into this on-demand session to learn how systems like Carle Health and Denver Health are leveraging Nabla to eliminate Pajama Time and build a future where agentic AI unlocks true workforce sustainability.
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Elevate 2025: Medallion’s Virtual Conference Returns September 17
Now in its fourth year, Medallion’s annual conference is back – bringing together healthcare leaders to explore this year’s theme: Elevate the present. Reframe the future of healthcare. Hear from industry voices like Tom Lawry, author of Hacking Healthcare, UPMC Chief Medical Information Officer Robert Bart, and many more. Reserve your spot now.
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- AI Science Breakthrough: Hallucination-Free Clinical Documentation: Abridge has invented a novel system to classify, identify, and eliminate hallucinations from medical documentation before they reach clinicians for final review. This technology performs 6x better than standard AI models at finding and fixing hallucinations. Abridge delivers the best-in-class ambient AI for healthcare by investing in foundational AI science and research. Read this game-changing interactive whitepaper to learn more.
- Are You Invisible on AI Search? Your next patient is asking ChatGPT. But unless your healthcare company has content that answers their questions, you won’t show up. Tely AI fixes this by analyzing your niche, identifying what patients and partners look for, and publishing expert-level content to make you visible on Google AI, ChatGPT, and Perplexity. Launch your AI agent in 5 minutes and get your first article on us.
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