How Does Carevive Align With FFS and Value – Based Reimbursement In The Future?

John Elliott from Carevive shares valuable insights gathered from recent conversations and on-site visits with partners and industry experts. The burning question on everyone’s mind is how Carevive aligns with the current fee-for-service reimbursement landscape and future value-based plans.

In the current state, Carevive seamlessly aligns with chronic care management codes, benefiting patients with treatment lasting longer than three months and requiring medication revisions. By proactively monitoring and managing patient symptoms, Carevive empowers care teams to avoid hospitalizations, driving a strong hard ROI.

Looking ahead to value-based reimbursement models, Carevive is already well-positioned. Aligned with the recent Oncology Care Model (OCM) and with its focus on driving transformation, quality metrics, and health equity, Carevive complements future redesign activities, including electronic patient-reported outcomes (ePROs) for remote symptom management.

Confident in its alignment with both current and future reimbursement models, Carevive remains committed to providing continuous engagement and improving patient outcomes. As the industry evolves, Carevive continues to stay at the forefront, fostering ongoing dialogue and serving as a reliable partner in the ever-changing landscape of oncology care. Stay tuned for more updates as Carevive continues to shape the future of cancer care.

Recent Episodes

Denials are no longer a slow leak in the revenue cycle—they’re a fast-moving, rule-shifting game controlled by payers, and hospitals that don’t model denial patterns in real time end up budgeting around losses they could have prevented. PayerWatch’s four-digit, client-verified ROI in 2024 shows what happens when a hospital stops reacting claim by…

Health insurers love to advertise themselves as guardians of care, but the real story often begins when a patient’s life no longer fits neatly into a spreadsheet. In oncology especially, “coverage” isn’t a bureaucratic checkbox—it’s the fragile bridge between a treatment that finally works and a relapse that can undo years of grit…

In “Fighting for Coverage,” a patient describes a double war: the physical fight to stay alive and the bureaucratic fight to prove to an insurer that her life is worth the cost. Her account spotlights a core tension in the U.S. system—coverage decisions are increasingly shaped by prior authorizations and desk-based reviewers who…