News & Analysis as of

Value-Based Care Medicare Healthcare

McDermott+

The Ambulatory Specialty Model: MIPS, MVPs, and APMs, oh my!

McDermott+ on

Stakeholders in the Medicare value-based care world have without a doubt heard of the Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), and alternative payment models (APMs). While all these initiatives...more

Jones Day

CMS Updates Kidney Care Choices Model

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The Center for Medicare and Medicaid Innovation ("CMMI") announced sweeping changes to the Kidney Care Choices Model ("KCC Model"), a key set of value-based programs....more

Jones Day

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

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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

Latham & Watkins LLP

CMS Seeks Healthcare Industry Input on Future of Digital Health

Latham & Watkins LLP on

Comments on the RFI, due by June 16, present a rare opportunity to shape future technology standards, reporting requirements, and business opportunities....more

Jones Day

Medicare's Innovation Center Charts New Direction: Part 2 – Digital Health and AI

Jones Day on

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

“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

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

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

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

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

Schwabe, Williamson & Wyatt PC

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

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

Sheppard Mullin Richter & Hampton LLP

Healthcare Industry Leaders Predict Four Areas to Watch After the U.S. Election: Takeaways from the Business of Health Care...

The recent U.S. election has had profound implications for the healthcare industry, prompting industry leaders to reexamine their strategies and day-to-day operations. At the Miami Herbert Business School’s annual “The...more

Jones Day

CMS Finalizes The Increasing Organ Transplant Access Model

Jones Day on

The Increasing Organ Transplant Access Model ("IOTA Model") introduces mandatory financial incentives and penalties for selected kidney transplant hospitals....more

Sheppard Mullin Richter & Hampton LLP

Navigating Gainsharing Pitfalls in Value-Based Models

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

Sheppard Mullin Richter & Hampton LLP

The Legal and Economic Realities of Medicare Drug Pricing: Navigating Opportunities and Challenges

The rising cost of prescription drugs under Medicare continues to pose significant challenges for seniors, a population that relies heavily on consistent and affordable access to medications. This issue underscores broader...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

Foley & Lardner LLP on

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

Foley Hoag LLP - Medicaid and the Law

CMMI Introduces New Multi-State Initiative Focused on Enhancing Primary Care Delivery

CMMI was established to test innovative payment and service delivery models expected to reduce expenditures and preserve or enhance care quality under Medicare, Medicaid, and the Children’s Health Insurance Program. Over the...more

McDermott Will & Schulte

Investing In a Healthier Future: The Investor’s Perspective On Value-Based Care

In this session, McDermott Will & Emery Partner Joel Rush moderated a discussion exploring investors’ interests in, opinions on and strategies for entering the value-based care (VBC) market. The panel discussed factors taken...more

McDermott Will & Schulte

Top Takeaways | Employer Market Perspective

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

Ankura

Writing a health equity plan? Don't start with your Community Needs Assessment

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Many health system leaders are developing health equity plans to participate in new value-based care payment models. The new ACO REACH payment model from the Center for Medicare and Medicaid Innovation (CMMI) has increased...more

Proskauer - Health Care Law Brief

CMS Responds to Industry Stakeholder Feedback, Redesigns and Renames the GPDC Model for DCEs as the ACO REACH Model

On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH)...more

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