I want to get continuous structured data on emerging value-based care models, provider quality metrics, and contract terms from competitor health plan provider portals and regulatory filings.
Access continuous insights on emerging value-based care models and quality metrics — effortless automation over tedious manual tracking
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Goal
I want to get continuous structured data on emerging value-based care models, provider quality metrics, and contract terms from competitor health plan provider portals and regulatory filings.
Source coverage
- cms.gov
- ncqa.org
- healthcare.gov
- kff.org
- ahip.org
- hcahpsonline.org
- medpage.com
- hrsa.gov
- medicare.gov
- nass.org
- healthaffairs.org
Sample data
Illustrative sample data from the original configuration, not live or verified results.
| id | Source | Model | Measure | Value | Benchmark | Contract Term | Effective Date | Status |
|---|---|---|---|---|---|---|---|---|
| 1 | cms.gov | ACO REACH | Hospital Readmission Rate (30-day) | 8.7% | CMS Nat'l Avg 11.2% | Performance-based shared savings/2-year | 2026-01-31 | Active |
| 2 | ncqa.org | PCMH Recognition v2025 | Diabetes HbA1c Control (<8%) | 72.4% | NCQA Peer 68.1% | Annual recognition renewal | 2026-01-30 | Awarded |
| 3 | healthaffairs.org | Value-Based Primary Care Pilot | Total Cost of Care per Member | $6,450 PMPY | Regional avg $7,200 PMPY | 3-year capitated agreement | 2026-01-29 | Under Evaluation |
| 4 | kff.org | Medicaid ACO Demonstration | Emergency Dept Visits per 1,000 | 210 visits | State avg 260 visits | 5-year demonstration waiver | 2026-01-31 | Reporting |
| 5 | medicare.gov | MA Value-Based Contract | Star Rating (Overall) | 4.5 stars | CMS threshold 4.0 | Annual contract with quality bonuses | 2026-02-02 | Finalized |
| 6 | ahip.org | Risk Adjustment Incentive | Risk Score Accuracy (R-squared) | 0.83 | Industry avg 0.78 | Performance bonus/1 year | 2026-01-28 | Implemented |
| 7 | hcahpsonline.org | Hospital VBP Program | Patient Safety Composite | 0.92 (normalized) | Nat'l median 0.85 | Quarterly pay-for-performance | 2026-02-03 | Active |
| 8 | medpage.com | Integrated Behavioral Health Bundle | Depression PHQ-9 Response Rate | 48% | Published trial 41% | 2-year bundled payment | 2026-01-30 | Pilot |
| 9 | hrsa.gov | CHC Value-Based Contracting | Preventive Visit Rate | 84% | HRSA target 80% | 3-year grant-aligned contract | 2026-02-01 | Active |
| 10 | nass.org | Orthopedic Episode Payment Model | Average Episode Cost | $16,200 | National median $18,400 | 90-day bundled payment | 2026-02-02 | Implemented |
| 11 | cms.gov | CMMI Primary Care First | Advance Care Planning Documentation | 36% of attributed pts | Program target 30% | 2-year participation | 2026-01-29 | Reporting |
| 12 | ncqa.org | Behavioral Health Integration Recognition | Follow-up After ED Visit (7-day) | 58% | NCQA target 60% | 12-month quality improvement plan | 2026-02-03 | In Progress |
| 13 | healthaffairs.org | Total Cost of Care Contract (Commercial) | Avoidable Admissions Rate | 78 per 10,000 | Market avg 95 per 10,000 | Shared savings w/ downside risk/1 year | 2026-01-31 | Under Negotiation |
| 14 | kff.org | Medicare ACO REACH Expansion | Social Risk Adjustment Implementation | Yes (implemented) | Peer ACOs partial | 3-year model participation | 2026-02-01 | Active |
| 15 | medicare.gov | Dual Eligible Integrated Plan | Care Transitions Follow-up (%) | 71% | CMS goal 70% | Annual integration contract | 2026-01-28 | Compliant |
| 16 | ahip.org | Specialty Pharmacy Value Contract | Medication Adherence (PDC) | 85% | Therapeutic class avg 78% | Performance rebate/12 months | 2026-01-30 | Live |
| 17 | hcahpsonline.org | Sepsis Care Bundle Pay-For-Performance | Timely Antibiotics (<1h) | 92% compliant | HCAHPS peer 88% | Quarterly incentive payments | 2026-02-02 | Active |
| 18 | medpage.com | Episode-Based Oncology Bundles | Mean Out-of-Pocket per Cycle | $342 | Market median $410 | 6-month bundled price guarantee | 2026-01-31 | Piloting |
| 19 | hrsa.gov | Rural Health Value Contracts | Telehealth Utilization Rate | 29% of visits | Rural avg 18% | 2-year federal support + value incentives | 2026-02-03 | Funded |
| 20 | nass.org | Spine Care Pathway (Commercial) | Reoperation Rate within 1 year | 3.1% | Specialty network avg 4.5% | Outcomes guarantee/2 years | 2026-01-29 | Guaranteed |
| 21 | cms.gov | Medicare Shared Savings ACO | Preventable Hospitalization Rate | 120 per 100,000 | Regional avg 150 per 100,000 | Shared savings w/quality lockbox/annual | 2026-02-01 | Active |
| 22 | ncqa.org | Patient-Centered Specialty Practice | Care Coordination Score (0-100) | 82 | NCQA median 75 | Recognition & quality-based payments | 2026-01-30 | Recognized |
| 23 | healthaffairs.org | Capitated Behavioral Health Model | Per Member Per Month (PMPM) Cost | $48.50 | Fee-for-service adj $62.00 | 24-month capitated contract | 2026-02-02 | Contracted |
| 24 | kff.org | State Medicaid Managed Care VBP | LTSS Avoidance Rate | 12.3% reduction | Baseline 0% | Value-based tiers/3 years | 2026-01-28 | Implemented |
| 25 | medicare.gov | Chronic Care Management Bundle | A1c Control (<7%) in T2DM | 39% | MA plan avg 35% | Monthly PMPM + quality add-on | 2026-02-03 | Monitoring |
| 26 | ahip.org | Provider Performance Network | Timely Specialist Referral (%) | 94% within 14 days | Network avg 88% | Pay-for-referral-performance/annual | 2026-01-31 | Active |
| 27 | hcahpsonline.org | Readmissions Reduction Incentive | 30-day Readmit Reduction | 22% relative reduction | Program target 15% | Gainsharing/2 years | 2026-01-29 | Exceeded |
| 28 | medpage.com | Remote Monitoring RPM Contract | Hypertension Control (<130/80) | 66% | Published cohort 60% | 12-month RPM subscription + outcomes refunds | 2026-02-01 | Scaling |
| 29 | hrsa.gov | FQHC Quality Incentive | Childhood Immunization Up-to-Date | 91% | HRSA goal 90% | Annual grant add-on | 2026-01-30 | Compliant |
| 30 | nass.org | Joint Replacement VBP | Post-op Infection Rate | 0.6% | National 1.2% | Bundled payment + penalty clause/90 days | 2026-02-02 | Active |
Insights and analytics
- Total Value-Based Care Models Identified (metric)
- Trends in Provider Quality Metrics Over Time (line)
- Distribution of Contract Terms by Competitor (pie)
- Top 5 Competitors by Provider Quality Score (bar)
- Value-Based Care Model Adoption Rates (donut)
- Most Common Contract Terms (horizontal_bar)
- Detailed Provider Quality Metrics (table)
- Cumulative Growth of Value-Based Care Models (area)
- Number of Regulatory Filings Reviewed (metric)
- Key Insights on Competitor Strategies (insights)
- Recent Changes in Contract Terms (table)
- Regulatory Changes Impacting Value-Based Care (line)
Change notifications
- New Model Detected — new model introduced cms.gov
- Contract Term Updated — contract terms have changed ahip.org
- Quality Metric Updated — new metrics available ncqa.org
- Benchmark Updated — new benchmark values found kff.org
- Product Removed — no longer listed healthaffairs.org
Integrations and delivery
- api
- bigquery
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