The Latest on Value Based Care
HealthLaw HotSpot - A Look at Alternative Reimbursement Models in Value-Based Care
Jones Day Talks Health Care: The Eliminating Kickbacks in Recovery Act
Value-based health care: fraud & abuse laws
Tax Developments Affecting Health Care Organizations and Investor-Owned Hospital Companies
The CMS Innovation Center has released the request for applications (RFA) for the Long-term Enhanced ACO Design (LEAD) model, a new 10-year accountable care initiative that will begin in 2027....more
On the heels of an executive order1 that is intended to reschedule medical marijuana and increase federal cannabidiol research, the Centers for Medicare & Medicaid Services (CMS) Innovation Center recently announced hemp...more
In its Final Rule for the 2025 Medicare Physician Fee Schedule, CMS announced changes to the Medicare Shared Savings Program (the Program) targeted at incentivizing providers to both enroll and stay in the Program. The Final...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
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
On April 27, 2021, CMS issued the fiscal year (FY) 2022 proposed rule for the hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (the Proposed Rule). Among...more
The Centers for Medicare & Medicaid Services (CMS) Innovation Center announced a Letter of Interest (LOI) for a new geographic model option within the Direct Contracting portfolio. The geographic model would transfer full...more
The Centers for Medicare and Medicaid Services (CMS) Direct Contracting Model presents an exciting move towards value-based care with benefits for participants, providers and patients alike. However, the model raises a number...more
In 2018, even more than in recent years, federal lawmakers and regulators continued the push toward modernizing the existing legal framework to support and encourage digital health adoption in the context of care coordination...more
Following a brief shutdown of the federal government, on February 9, Congress passed and President Donald J. Trump signed into law the Bipartisan Budget Act of 2018 (Budget Act), which provides Congress until March 23 to...more
On February 9, 2018, Congress passed and the President signed into law the Bipartisan Budget Act of 2018 (BBA). This wide-reaching legislation enacts major changes for telehealth policy in Medicare by incorporating policies...more
Telehealth continues to be a frontrunner on one strategy to achieve the triple aim, an effort to improve patient experience, population health and reduce per capita cost. To date, government reimbursement for telehealth...more
Last week, the Congressional Budget Office (CBO) concluded that a key piece of telehealth legislation, the CHRONIC Care Act of 2017, would not, overall, increase or decrease Medicare spending. This score is significant as it...more
Collaborative efforts between congressional offices and various health care stakeholders, as well as the feedback provided in response to the Bipartisan CHRONIC Care Working Group Policy Options Document released in December...more
On July 7, 2016, CMS issued a proposed rule that updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2017 (Proposed...more
In keeping with the boom of telehealth legislation introduced last year at both the state and federal level, the Senate Finance Committee is considering several policy changes that, if ultimately enacted, could make...more
The Senate Finance Committee chronic care working group recently released a Policy Options Document continuing an effort that started with a hearing titled, “Chronic Illness: Addressing Patients’ Unmet Needs” in the summer of...more
On December 18, 2015, the United States Senate Committee on Finance (the Committee) released a Bipartisan Chronic Care Working Group Policy Options Document), which outlines approaches under consideration to improve the care...more
This Week: House E&C 21st Century Cures Bill Passes Unanimously Out of Committee... House Votes to Codify Permanent R&D Tax Credit... CMS Released Proposed Rule Concerning Medicaid and CHIP Plans....more