The Center of Gravity Has Shifted
Healthcare’s shift to Value-Based Care (VBC) is accelerating, with mandatory participation and tighter benchmarks pulling providers into increased risk faster than ever. Post-acute care is a major, often overlooked driver of cost and quality. Without real-time visibility, organizations face avoidable readmissions, extended length of stay, and fragmented transitions—all of which threaten margins and patient outcomes.
Bottom Line: As CMS expands mandatory models and downside risk grows, post-acute visibility is no longer optional: it’s the key to thriving in VBC and alleviating throughput pressures.
Beyond Discharge: Why Post-Acute Care Defines Outcomes
As the center of gravity in healthcare shifts decisively toward Value-Based Care (VBC), providers are being pulled into risk faster than ever before. Mandatory participation, tighter benchmarks, and escalating downside financial exposure are no longer distant possibilities, they’re today’s reality. In this environment, success hinges on more than acute care excellence; it requires visibility across the entire continuum, especially post-acute care.
Why? Because what happens after discharge from the hospital can determine whether you meet quality targets, protect margins, and deliver the outcomes VBC demands. Post-acute care is no longer a peripheral concern—it’s the linchpin of sustainable performance.
This blog explores why post-acute insight is essential for alleviating throughput pressures, reducing avoidable readmissions, and positioning your organization to thrive in a rapidly evolving landscape.
Value-Based Care (VBC) isn’t just reshaping healthcare—it’s rapidly becoming the dominant model. While the 2030 goal of moving every Medicare beneficiary into a value-based arrangement remains a major milestone, the pace and nature of change have intensified. In 2025, 476 Medicare Shared Savings Program (MSSP) ACOs are participating, covering more than 14.8 million lives. But the real shift is in the details:
- TEAM is now the first broadly mandatory hospital model with mandatory downside risk, marking a significant departure from previous voluntary models.
- MSSP is accelerating the transition by reducing the number of years an ACO can remain in upside-only arrangements by two years, pushing organizations into risk-bearing contracts sooner.
- Benchmarks are tightening, opt-outs are fewer, and providers must adapt quickly to avoid compromising care or margin.
In short, the question isn’t if you’ll need to adapt—it’s how quickly you can do it, given these new, more demanding requirements.
Why Post-Acute Care Is the Critical Connector in the Care Continuum
Post-acute care (PAC) is often the blind spot in VBC strategies, yet it represents one of the most variable—and controllable—cost drivers. Without visibility into PAC, organizations face:
- Avoidable readmissions that trigger penalties and erode quality scores
- Extended length of stay (LOS) that blocks beds and inflates costs
- Fragmented transitions, where care management may lose track of patients during critical periods—especially right after a transition, when avoidable readmissions are most likely.
In short, what happens after discharge can undo everything you’ve worked to achieve inside the hospital walls.
Throughput Pressures: The Hidden Margin Killer
Today’s reality:
- ED boarding and delayed discharges are rising due to staffing shortages and higher volumes
- High-margin procedures are postponed because beds are locked by patients awaiting placement
- Manual, paper-based processes slow transitions and frustrate staff
Every unnecessary day in acute care adds cost and blocks revenue. Under VBC, it also jeopardizes benchmark performance and exposes you to downside risk.
What Providers Need Now
To succeed in this environment, organizations need real-time insight into post-acute care. That means:
- Visibility across the continuum to track patient progress
- Predictive intelligence to identify readmission risk early
- Streamlined workflows that accelerate safe, appropriate transitions
- Data-driven decision-making to optimize network performance and reduce spend
These capabilities aren’t aspirational; they’re essential for meeting quality targets, protecting margins, and improving patient outcomes.
Signals You Can’t Ignore
- CMS is expanding mandatory models like TEAM for surgical episodes in 2026 (https://innovation.cms.gov/).
- Benchmarks are tightening, and downside risk is becoming unavoidable.
- Post-acute spend remains one of the most variable—and controllable—cost drivers in VBC.
Organizations that act now will position themselves for success. Those that delay risk financial penalties, operational strain, and competitive disadvantage.
Optimism and Opportunity
Here’s the good news: providers who embrace post-acute visibility aren’t just mitigating risk—they’re unlocking opportunity. Better patient flow means:
- Reduced LOS and throughput relief
- Improved patient experience and outcomes
- Stronger financial performance under VBC models
You’re not alone in this journey. Partnering with experts who understand the complexity of cross-continuum care ensures you have the tools, insights, and support to thrive—not just survive—in this new era.
Your Next Step
Post-acute visibility is no longer optional—it’s the key to succeeding in VBC and alleviating throughput pressures.
Learn how leading health systems are leveraging post-acute insight to improve patient flow, reduce readmissions, and protect margins.
