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Medicaid › Healthcare Reform › Value-Based Care

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Sheppard Mullin Richter & Hampton LLP

State-Directed Payments, Value-Based Care, and the “One Big Beautiful” Bill: A Comprehensive Analysis

Sheppard Mullin Richter & Hampton LLP on

Among the many sweeping changes to the Medicaid program included in the One Big Beautiful Bill Act (“OBBBA”), Congress established new statutory caps on state-directed payments (“SDPs”) in Medicaid managed care. SDPs have...more

Jones Day

Medicare's Innovation Center Charts New Direction: Part 3 – Drugs, Devices, and Data

Jones Day on

The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the third of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding drugs,...more

McDermott+

A Deep Dive Into the CMS Program Management FY 2026 Budget Request

McDermott+ on

As discussed in last week’s Regs & Eggs blog post, the US Department of Health and Human Services (HHS) recently released additional budget documents to support the department’s fiscal year (FY) 2026 discretionary request....more

Jones Day

Medicare's Innovation Center Charts New Direction: Part 1 - Providers

Jones Day on

The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the first of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding health care...more

Sheppard Mullin Richter & Hampton LLP

Takeaways from the America’s Physician Groups’ Spring Conference: Turbulent Times Call for Change and Innovation

Sheppard Mullin Richter & Hampton LLP on

“Kicking Off Accountable Care” served as the theme for this year’s America’s Physician Groups’ (“APG”) Spring Conference, a three-day event packed with compelling speakers and breakout sessions focused on the state of...more

Mintz - Health Care Viewpoints

CMMI Unveils New Strategic Direction: Preventive Care, Patient Empowerment, and Competition

Mintz - Health Care Viewpoints on

The Center for Medicare and Medicaid Innovation (CMMI) recently announced a new strategic direction during a public webinar and accompanying white paper, outlining its evolving priorities under the current administration....more

Holland & Knight LLP

CMMI's New Strategic Direction: What to Know

Holland & Knight LLP on

Following the announcement that four Center for Medicare and Medicaid Innovation (CMMI or Innovation Center) models will end in 2025, the Centers for Medicare & Medicaid Services (CMS) has begun signaling what's next for the...more

Bass, Berry & Sims PLC

CMMI Announces New Strategy

Bass, Berry & Sims PLC on

After months of signaling that a new strategy was in the works, on May 13, 2025, the Centers for Medicare & Medicaid Services (CMS) released a new strategic direction for the CMS Center for Medicare and Medicaid Innovation...more

Bass, Berry & Sims PLC

Healthcare Regulatory & Compliance Summit 2025 Recap

Bass, Berry & Sims PLC on

Health Policy Fireside Chat: What to Expect from the New Administration - Bill Mathias, Member at Bass, Berry & Sims, engaged in a fireside chat with Colin Roskey, Principal at FHP Strategies, former Deputy Assistant...more

Benesch

Dialysis & Nephrology Digest - April 2025

Benesch on

ESRD ETC among value-based care models being ended early by CMS - This decision to end the ESRD ETC payment model and several others on Dec. 31 aligns with CMS’ goal to focus on models that demonstrate potential for...more

Jones Day

CMS Innovation Center Announces Cost-Saving Restructuring of Value-Based Payment Model Portfolio

Jones Day on

The Center for Medicare and Medicaid Services ("CMS") has announced significant changes to its value-based payment model portfolio projected to save $750 million as part of a shift in the agency's refocused strategy toward...more

Mintz - Health Care Viewpoints

What to Take Away from CMMI’s Early Termination of Four Demonstration Models

Mintz - Health Care Viewpoints on

On March 12, 2025, in one of the Trump Administration’s first actions with respect to the Center for Medicare and Medicaid Innovation (CMMI), CMMI announced that it would prematurely terminate four alternative payment model...more

Holland & Knight LLP

CMMI Signals New Strategy and Terminates 4 Value-Based Care Models

Holland & Knight LLP on

The Center for Medicare and Medicaid Innovation (CMMI) has released a statement on plans to unveil a new strategy focused on "improving the health of Americans through disease prevention via evidence-based practices,...more

Foley & Lardner LLP

Medicare Payment Model Trends and Economic Drivers – Awaiting Direction from Trump Administration

Foley & Lardner LLP on

The Medicare program continues to face long term financial pressures associated with inflationary effects on health care costs and the growing wave of aging baby boomers. The Medicare Trust Fund, which is often viewed as a...more

McDermott+

Value-Based Care at a Crossroads: What’s Next and How To Prepare

McDermott+ on

The Trump administration will have its own vision on value-based care, creating specific priorities for the Center for Medicare & Medicaid Innovation (CMMI), the federal government’s primary testing ground for payment and...more

Sheppard Mullin Richter & Hampton LLP

Medicaid in the Crosshairs What Restructuring Could Mean for States, Providers, and Beneficiaries

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As budget negotiations heat up in Washington, Medicaid has emerged as a key target for cost-cutting measures. With policymakers looking to trim federal spending while maintaining commitments to Social Security and Medicare,...more

Whiteford

Navigating Value-Based Care in Anesthesia: Enhancing Patient Outcomes Amid Legal Complexities

Whiteford on

Value-based care (VBC) is a healthcare delivery model that prioritizes patient outcomes over the volume of services provided. This approach aims to enhance the quality of care while controlling costs by incentivizing...more

Sheppard Mullin Richter & Hampton LLP

Navigating Gainsharing Pitfalls in Value-Based Models

Sheppard Mullin Richter & Hampton LLP on

As the shift toward value-based care continues to transform the healthcare industry, hospitals and health systems are increasingly utilizing incentive-based physician compensation structures. Incentive-based compensation...more

Akerman LLP - Health Law Rx

CMS Tells States and Providers: Value-Based Care is the Answer

Akerman LLP - Health Law Rx on

The Centers for Medicare & Medicaid Services (CMS) has sent a clear message to states and providers: they already have the tools to improve healthcare. Through a combination of value-based arrangements and already existing...more

Polsinelli

Health Care Reimbursement and Payor Dispute Update Special Edition – Year End Regulatory Review

Polsinelli on

The Centers For Medicare & Medicaid Services Issues New Inpatient Prospective Payment System Final Rule - On September 3, 2020, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2021 Medicare...more

Sheppard Mullin Richter & Hampton LLP

Global and Professional Options Direct Contracting Model RFA and LOI Now Active

Sheppard Mullin Richter & Hampton LLP on

On April 21, 2019, the Center for Medicare and Medicaid Innovation (“CMMI”) announced the CMS Primary Cares Initiative – a voluntary, risk-based initiative to transform the Medicare program’s reimbursement of primary care...more

Ballard Spahr LLP

CMS and OIG Release Long-Awaited Stark Law and Anti-Kickback Statute Proposed Rules

Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) recently released two proposed rules restructuring the Physician Self-Referral...more

Foley & Lardner LLP

Healthcare Law Review: Overview of the U.S. Healthcare System

Foley & Lardner LLP on

The U.S. healthcare industry remains at a crossroads. The healthcare reform legislation passed under President Barack Obama in 2010, officially called the Patient Protection and Affordable Care Act (ACA) but widely referred...more

Farrell Fritz, P.C.

The Healthcare Revolution Impacting Social Service Agencies

Farrell Fritz, P.C. on

While the fight in Washington has been focused on the future of Obamacare, here in New York a healthcare revolution is well underway. Over the past several years, major changes in New York healthcare laws and regulations have...more

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