5 plans of attack: How payers can succeed facing new CMS rules in 2025 – and beyond

5 plans of attack: How payers can succeed facing new CMS rules in 2025 – and beyond

Some of the Centers for Medicare and Medicaid Services (CMS) changes represent a paradigm shift away from tradition, including new caps on out-of-pocket spend and sweeping health equity mandates. The good news is, these changes broaden opportunity for health plans, providers and patients alike – especially those who proactively embrace the shift toward preventative, value-based care. 

Lirio Establishes the Value of a Primary Care Visit for Patients with Diabetes to Health Systems

Lirio Establishes the Value of a Primary Care Visit for Patients with Diabetes to Health Systems

Diabetes is associated with significant long-term costs for both patients and health systems. Regular primary care visits aligned with American Diabetes Association guidelines could help mitigate those costs while generating near-term revenue for health systems. Digital interventions prompting primary care visits among unengaged patients could provide significant economic value back to the health system as well as individual patients, but only few economic models have been put forth to understand this value. Lirio’s model has been published in JMIR Formative.