Health care M&A
On May 17, the Senate Finance Committee released a long-awaited white paper describing its legislative effort focused on bolstering chronic care through physician payment. Following a committee hearing April 11, the white...more
Over the last several months, the Center for Medicare and Medicaid Innovation (CMMI), within the Centers for Medicare & Medicaid Services (CMS), has introduced several alternative payment models (APMs) geared toward...more
State governments are increasingly entering the field of health care market oversight and enforcement. In what was once an issue typically left to the federal government, state governments are looking for ways to...more
Pursuant to California's Health Care Quality and Affordability Act (the "HCQA"), the newly created Office of Health Care Affordability ("OHCA") recently proposed statewide health care cost targets and standards and goals for...more
The Centers for Medicare & Medicaid Services (CMS) recently announced the ACO Primary Care Flex Model (ACO PC Flex Model or Model), a new voluntary payment model for primary care furnished through low-revenue Accountable Care...more
The goal of value-based care (VBC) is to promote better care for individual patients and improved health outcomes for communities at reduced costs. This is an important and admirable purpose as many VBC stakeholders attempt...more
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
Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...more
As physician groups and other stakeholders work to finalize comment letters on the calendar year (CY) 2024 Physician Fee Schedule (PFS) proposed regulation by September 11, 2023, the Centers for Medicare & Medicaid Services...more
The Centers for Medicare & Medicaid Services (CMS) published a Request for Information (RFI) on July 18 regarding the design of a future, episode-based payment model on behalf of CMS’s Center for Medicare and Medicaid...more
In this session, panelists focused on the unique challenges and opportunities facing health systems as they move into value-based care (VBC)...more
The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Medicare Physician Fee Schedule (PFS) Proposed Rule on July 7, 2022, which impacts Medicare Part B payments starting Jan. 1,...more
As state leaders continue to grapple with unsustainable rates of health care cost growth, benchmarking programs have continued to proliferate across states as a strategy for better understanding health care cost drivers,...more
President Biden set an ambitious health care agenda in his campaign and maintained that focus as he took office. The Biden administration has expressed a strong commitment to “protect and build on the Affordable Care Act,...more
February Spotlight - In each edition, Manatt will feature a “deep dive” topic that shares new cross-cutting benchmarking program developments as states seek to evolve and advance their cost growth benchmarking programs to...more
On November 2, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) that advances the shift from paying for Medicare home health services based on volume to a system that pays based on...more
Introduction - The vision of primary care as the foundation for all health care is one shared by many who work in and around the U.S. health care system. Patients, policymakers, providers, payers and purchasers generally...more
The Centers for Medicare & Medicaid Services (CMS) on July 19, 2021, released its calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed...more
As states grow increasingly concerned with rising health care costs, establishing health care cost growth benchmarking programs can provide a structure and process for increasing health system transparency and developing...more
Learn How States Are Using Cost Growth Benchmarking to Increase Health System Transparency and Contain Rising Health Care Costs at a New Manatt Webinar. As states grow increasingly concerned over soaring health care costs,...more
In this week's episode, Gabe Scott and Steve Pine discuss recent data showing how health systems participating in Alternative Payment Models compare to other health systems in responding to the COVID-19 crisis, and discuss...more
As discussed in a previous alert from March 24, 2020, due to the 2019 novel coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) announced it would temporarily ease quality reporting...more
CMS recently announced updates and milestones for several programs run by the Center for Medicare and Medicaid Innovation (CMMI). CMMI is the internal CMS agency responsible for developing and testing new health care payment...more
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
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B,...more