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Medicaid › Value-Based Care › Health Care Providers

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

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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 1 - Providers

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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

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“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

Bass, Berry & Sims PLC

Healthcare Regulatory & Compliance Summit 2025 Recap

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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

Holland & Knight LLP

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

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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

Bass, Berry & Sims PLC

CMS Terminates Four Value-Based Care Models Early and Signals New Strategy

Bass, Berry & Sims PLC on

On March 12, the Centers for Medicare & Medicaid Services (CMS) announced that certain Medicare value-based payment models will terminate early and signaled a new strategy will be announced soon. Specifically, the Centers for...more

Schwabe, Williamson & Wyatt PC

How Might Oregon and Washington healthcare providers be effected by proposed Medicaid cuts?

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On February 25, House Republicans narrowly passed a budget resolution that requires the House Energy and Commerce Committee to find $880 billion in spending cuts over the next 10 years. Budget realities—including the fact...more

Foley & Lardner LLP

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

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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

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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

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

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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

Foley & Lardner LLP

Behavioral Health: CMS Innovation Model Outlines Changes for the Delivery of Integrated Behavioral and Physical Health Care

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On January 18, 2024, the Centers for Medicare & Medicaid Services (CMS) announced a new innovation model designed to improve quality of care and behavioral and physical health outcomes for Medicaid and Medicare patients with...more

Foley & Lardner LLP

2024 Predictions: Unveiling the future of healthcare mergers and acquisitions

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Today, a tale of two markets are seen in healthcare mergers and acquisition (M&A): the present (as reflected in the data about declining dealmaking) and the future (reflected in the increasingly positive outlook by...more

Health Care Compliance Association (HCCA)

[Event] 2024 Managed Care Compliance Conference - January 29th - 30th, Coronado, CA

Health Care Compliance Association (HCCA) on

Explore the unique issues that are pertinent to managed care professionals! This annual event dedicated to compliance management for health plan providers is returning to an in-person format for 2024. Join your peers and...more

Mintz - Health Care Viewpoints

Transforming Primary Care: CMS Launches Making Care Primary (MCP) Model

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The Centers for Medicare & Medicaid Services (CMS) announced a new primary care model—the Making Care Primary (MCP) Model—geared towards smaller, independent primary care practices and organizations that want to participate...more

Health Care Compliance Association (HCCA)

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Health Care Compliance Association (HCCA) on

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

McDermott Will & Schulte

Top Takeaways | Employer Market Perspective

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In this session, McDermott Will & Emery Partner Patrick Healy moderated a panel that examined the expansion of value-based care in the employer market. We summarize the panel’s insights on how stakeholders can successfully...more

McDermott Will & Schulte

VBC Symposium 2023 | Innovations in Value-Based Care for Complex Populations

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During this session, Partner Jeremy Earl moderated a panel that discussed how value-based care models are delivering care to individuals with complex conditions and those with significant healthcare and social needs. The...more

Sheppard Mullin Richter & Hampton LLP

Day 1 Notes from the 41st Annual J.P. Morgan Healthcare Conference

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I was struck on the first day of the 41st Annual J.P. Morgan Healthcare Conference by Sanjay Doddamani (CEO of UpStream Healthcare) saying that “Health is a state of independence.” A simple statement, but a very profound and...more

Holland & Knight LLP

Holland & Knight Health Dose: November 22, 2022

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include: ...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Health Care Compliance Association (HCCA) on

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

McDermott Will & Schulte

Massachusetts Enacts Legislation Promoting Access to Quality and Affordable Care, Telehealth

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On January 1, 2021, Governor Charlie Baker signed an omnibus healthcare law entitled “An Act promoting a resilient health care system that puts patients first,” which is aimed at addressing pressing healthcare issues in...more

Sheppard Mullin Richter & Hampton LLP

Evaluation of Innovation Center Models

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On January 13, 2021, Brad Smith, the current (and fourth) director of the Center for Medicare and Medicaid Innovation (the “Center”), published an article in the New England Journal of Medicine in which he evaluates the...more

Akerman LLP - Health Law Rx

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

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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

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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

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