Over the past few weeks, I’ve been catching up with the team at WellSky, and wanted to share some learnings from them in this post. More and more, I’m seeing a huge theme emerge, especially with the emergence of AI: health systems crave interconnected systems, and the more data you have in one platform, the better the entire system will run across teams, in true multidisciplinary fashion.
So, to that end, WellSky’s bet is that whoever builds the connective tissue across care settings, in collaborative fashion, is the one best positioned to win in healthcare’s next chapter given looming regulation, current challenges, and what the future of health system transformation looks like.
Across the country, WellSky is helping health systems operationalize TEAM, support ED throughput, and reduce readmissions with a platform built for multidisciplinary care coordination. They’re creating and driving connectivity between provider and payor clinical teams where it doesn’t exist and where bad blood doesn’t have to run. Where sensitive information can be shared without divulging competitive intel or trade secrets, and while mitigating concern that it could be detrimental to one side. And we can begin to foster collaborative efforts for patients and see better results, both clinically and financially, for all stakeholders.
I’ve memorialized my thoughts and opinions on the future of this space in the sections below. This includes a breakdown of who WellSky is, how they’re working with hospitals and health systems across the country on solving some of their hardest problems (ED throughput, care navigation, network leakage), what they’re doing right now to help hospital leaders prepare for what’s next (AKA, TEAM), and why their “neutral broker” model is a great path forward for healthcare in creating a win-win you haven’t been paying enough attention to.
See how WellSky is transforming healthcare organizations.
Who Is WellSky?
WellSky is the Switzerland of healthcare, acting as a point between clinicians and connecting them across inpatient, post-acute, outpatient, home health, and everything in between. They’re neutral, technology-first, data-rich, and designed to help clinical teams focus on next best actions for their specific workflows given specific patient needs. As a leading connectivity company for healthcare, WellSky is building the web that lets payors, providers, and other risk bearing organizations finally collaborate around the same patient reality.
Instead of piling new tools onto old workflows or adding more screens or clicks, WellSky’s platform focuses on one organizing idea: integrate and embed deeply into existing workflows, aggregate, and, once systems are inter-connected, give clinical teams on every side an objective, holistic view of a patient. From there, teams leverage WellSky’s platform to coordinate and optimize for what’s best for the patient. When the work is framed that way and the entirety of a patient’s longitudinal data is available for care coordination purposes, hospital operators are able to streamline operational efforts, clinician satisfaction improves, and patients feel the difference across emergency, inpatient, and post acute settings.
While others are stuck trying to “overlay AI” on top of fragmented, outdated systems, WellSky built an infrastructure with integration in mind from day one that’s focused on driving true care coordination. Their platform includes:
- A connected network of 2,000 hospitals, and 130,000 providers across post-discharge services
- 54 million referrals and 17 million discharges per year flowing through their systems
- Real-time clinical visibility, including useful ADTs (not just “the patient is here,” but why they’re there), and intervention capabilities
- Proven workflows embedded directly in hospital and post-acute environments
- Comprehensive data across the continuum with exceptional clinical AI summarization fidelity
This platform scale allows risk-bearing entities to operate a full acute-to-post-acute clinical model, access and share robust clinical data to deliver better patient outcomes, and coordinate better handoffs between clinical organizations.
What WellSky is Doing
Diving into and contextualizing what WellSky is doing for hospitals, health systems, and risk-bearing organizations, here are four ways WellSky is currently working with customers to act as a transformational partner in helping them set themselves up for an economically viable, sustainable future.
1. Supercharging ED Throughput and Connecting Patients to the Right Point of Care
The ED is where many patient stories start. But for many hospitals, it’s also where operational chaos and margin erosion begin.
- Frequent fliers
- Observation stays
- Patients admitted because they don’t have a PCP or a safe discharge plan
Sound familiar?
Here’s where things get fascinating: WellSky recently launched a proprietary ED transition program across nearly 100 EDs nationwide. The program aims to:
- Significantly reduce unnecessary hospitalizations among supported patients
- Increase follow-up rates with outpatient providers within 14 days of discharge
- Enhance inpatient mix by proactively connecting patients with the right resources, helping keep them out of the ED while driving higher acuity admissions and stronger margins
From an implementation perspective, the ED Transitions from WellSky empowers a dedicated team of clinical coordinators to work within the hospital’s existing system of record and ED workflows. These coordinators access real-time patient information—including historical medical records, recent medications, care programs, and available post-discharge services—to support safe and appropriate discharge planning. Leveraging WellSky’s technology and provider network, the clinical coordination team actively engages with on-site staff to ensure that the next steps in care are scheduled before the patient leaves the ED, facilitating seamless transitions to home health, skilled-nursing facilities, or primary care as needed.
WellSky’s playbook is one that benefits everyone:
- Hospitals reduce preventable admissions and protect (or expand) margins while increasing ED throughput
- Payors and risk-bearing entities avoid unnecessary costs
- Patients get routed to the right care setting and receive supports, not just admitted by default, and are seen and heard
As we know, for health systems, the ED isn’t a cost center; it’s one of the most important patient acquisition funnels. WellSky aims to turn it into an optimized, strategic lever to boost acuity levels at your ED and put patients in the right care setting.
2. Closing the Loop on Readmissions
In a hospital and value-based world, readmissions are top of mind because the financial penalties hit patients and bottom lines hard. And with CMS proposing changes to include both Medicare and Medicare Advantage in the Hospital Readmission Reduction Program 30-day measure calculation, the stakes just got higher – along with the need for coordination and collaboration with MA players and risk-bearing groups holding risk for those patients.
For hospitals, that means:
- The better you support transitional care management between inpatient and outpatient providers, the less likely your patients will return to the ED or be readmitted
- With HRRP (hospital readmission reduction penalties), you need to find a way to work with MA plans and risk-bearing groups around readmission reduction (this dynamic is going to become a requirement in short order, so wrap your head around it now)
- Coordination is not optional (there’s only so much you can do within your own playground, so you have to play nice)
WellSky filled me in on some of the ways they’re working with hospital clients to support readmissions challenges. As one example, WellSky deployed 12 local transitional care coordinators at a Florida-based ACO, leading to the following results:
- 15% drop in 60-day readmissions
- Approximately $8M+ in SNF savings
- Members 2x more likely to be discharged to a high-performing SNF vs. market average
This is what happens when the tech actually connects the care teams and incentives – like readmissions penalties – align between providers and risk-bearing groups. And you should expect to see more regulation similar to this readmission penalty emerge as CMS works to foster collaboration.
From the WellSky side, whether the discharge is going from the hospital to a SNF, home health, or back to the PCP, WellSky has the tools, and the network, to make the handoff seamless. That means less rework, fewer duplicative tests, and a real shot at breaking the readmission cycle. For execs asking how to drive both clinical and financial ROI, you should consider at least chatting with WellSky to see if their platform makes sense for you.
3. Prepping for TEAM and Beyond as CMS Will Continue to Mandate Future Alternative Payment Models in Hospitals
On January 1, 2026, 748+ hospitals will enter TEAM (Transforming Episode Accountability Model), CMS’ 5-year, mandatory bundled payment model for 5 surgical episodes. That’s hundreds of hospitals required to take on financial risk for certain surgical and medical episodes starting January 2026.
Although they didn’t opt into TEAM, hospitals that are unprepared can at least choose who helps them survive it. WellSky is having ongoing conversations with several hospital partners who are feeling that they are behind on getting ready for the reporting requirements, care coordination needs, and more that a mandatory longer-term bundle requires. If hospitals aren’t prepared, they’re going to see significant financial penalties which impacts their ability to thrive and compete in their local markets.
Some hospitals are ready with their bundles. But some are just now asking how long it takes to stand up a program (the answer is at least 90 days so pick up the phone ASAP) and the clock is ticking to avoid a big CMS penalty six months in.
Thankfully for them, WellSky’s value prop works to prepare hospitals for TEAM, and whatever may be next beyond TEAM:
- Plug into WellSky’s tech and services;
- Use their clinical and administrative labor pool and other resources to manage your TEAM episodes and optimize staffing;
- Build toward broader population health capabilities, without spinning up an internal team from scratch (instead, work with a partner until critical mass)
The big takeaway here: while TEAM is introducing mandatory downside risk, it’s also a wake-up call that value-based care – or at least, components of it – is here to stay. Hospitals see TEAM as the forced introduction to more sophisticated VBC. Even those who have been reluctant to consider risk-based models are now thinking broadly about how they can work smarter with payors in their region or diversify revenue through potential shared savings or other risk arrangements. Go ahead and future proof your operation before you get stuck playing chronic catch-up.
4. Extending Home Health’s Reach
Today’s home health labor pool is constrained. When agencies can’t reach all of the eligible patients, it drives the readmissions problem for hospitals.
WellSky offers a comprehensive, all-in-one platform for home healthcare organizations, specifically focused on solving the challenge of the constrained labor pool and its link to hospital readmissions.
WellSky’s strategic goal is to extend home health’s reach by maximizing resource efficiency. The company’s AI-powered EHR technology and centralized management platforms bring intelligence to operations, actively optimizing critical areas like:
- Route optimization for the home health labor pool, increasing service capacity.
- Ambient listening and clinical workflow support, freeing up clinician time.
- Medication reconciliation to streamline the start of care.
The platform also enables providers to excel in value-based care by facilitating timely access and strategic expansion:
- Going upstream to partner with hospitals and health plans.
- Efficiently accepting time-sensitive referrals out of the ED.
- Supporting timely starts of care for high-risk patients.
WellSky is also seeing a lot of pilots with risk-bearing entities as home health redefines its industry in the midst of reimbursement reduction from CMS. There are a lot of requests from home health agencies on how they can support the clinical-based PCPs, the ED, and SNF.
Why All This Matters Now
Healthcare is already changing.
- More Medicare (and MA!) patients
- More risk-based models
- More revenue tied to performance on coordination and outcomes (CMS asking for more from hospitals – and forcing, in certain instances)
Hospitals that ignore this shift are setting themselves up to lose on revenue, quality benchmarks, and patient trust. But hospitals that lean into connectivity, build partnerships, and embrace infrastructure designed to flex with this new reality will be poised to shape the emerging future of care delivery with aggregated data and multidisciplinary care teams.
So, if your team is still using faxes, still siloed off from MA plans, or still treating care transitions as one-and-done discharge notes, this article from yours truly is your sign to stop, rethink, and consider who you need to connect with.
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