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The Centers for Medicare & Medicaid Services (CMS) Innovation Center has announced the Long-term Enhanced ACO Design (LEAD) Model — a 10-year initiative designed to advance value-based care for Medicare beneficiaries,...more
During the Nelson Mullins 2025 Annual Value-Based Care Forum, Navigating Opportunities in a Value-Driven World, virtual attendees submitted questions for the panelists to answer. Below are the panelists’ responses, which...more
On December 18, 2025, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced the Long-term Enhanced ACO Design (LEAD) Model, a voluntary accountable care organization (ACO) initiative set to launch...more
Providers and provider organizations are increasingly contracting with payors to manage specific patient pools and diseases on a risk basis. They are taking new and increasing financial risk to better align with payors’...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
After a protracted comment period, the California Department of Managed Health Care (the “Department”) formally adopted its much anticipated “global risk” regulation (the “Regulation”), which will go into effect on July 1,...more
This may not be obvious to people who do not keep track of the Federal Trade Commission (FTC)/Department of Justice antitrust enforcement policy, but an enforcement action has never been published involving an Accountable...more
California's Department of Managed Health Care ("DMHC") has proposed regulations that could require accountable care organizations ("ACOs") and other entities that assume "global risk" to obtain licensure as a health care...more
It has been over three years since the Centers for Medicare and Medicaid Services (CMS) announced its proposed rule and guidance on the development and implementation of Accountable Care Organizations. About four million...more