News & Analysis as of

Alternative Payment Models (APM) Healthcare Reform

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

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

Mintz - Health Care Viewpoints

What to Take Away from CMMI’s Early Termination of Four Demonstration Models

On March 12, 2025, in one of the Trump Administration’s first actions with respect to the Center for Medicare and Medicaid Innovation (CMMI), CMMI announced that it would prematurely terminate four alternative payment model...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

McDermott+

No Doc Fix or Advanced APM Bonus: What Happens Next?

McDermott+ on

Here we go again! For the second year in a row, we enter the new year without Congress enacting a doc fix or Advanced Alternative Payment Model (APM) bonus extension. While Congress did act last year on both counts (through...more

McDermott+

ACO REACH: What Recent Performance Results Could Mean for the Model’s Future

McDermott+ on

Decisions, decisions, decisions. The Centers for Medicare & Medicaid Services (CMS) under the Trump Administration will have its hands full making decisions about Center for Medicare and Medicaid Innovation (CMMI) models...more

McDermott+

A Buffet of Hospital Alternative Payment Models: Will Too Many Entrees Be Overwhelming?

McDermott+ on

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

Jones Day

California Health Care Providers to Face Greater Headwinds as State Implements Health Care Cost Targets

Jones Day on

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

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

Hall Benefits Law on

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

McDermott+

House Holds Hearing on MACRA Challenges, but Meaningful Reform is Unlikely

McDermott+ on

On June 22, 2023, the US House of Representatives Committee on Energy and Commerce Subcommittee on Oversight and Investigations held a hearing titled “MACRA Checkup: Assessing Implementation and Challenges that Remain for...more

McDermott Will & Emery

Top Takeaways | 2023 Value-Based Care Symposium | Health System Innovation in Value-Based Care

McDermott Will & Emery on

In this session, panelists focused on the unique challenges and opportunities facing health systems as they move into value-based care (VBC)...more

Proskauer - Health Care Law Brief

CMS releases guidance on Expanded Home Health Value-Based Purchasing (“HHVBP”) Model

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

Sheppard Mullin Richter & Hampton LLP

Global and Professional Options Direct Contracting Model RFA and LOI Now Active

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

Bricker Graydon LLP

HHS regulatory sprint to coordinated care: Will meaningful changes make it across the finish line?

Bricker Graydon LLP on

As part of the U.S. Department of Health and Human Services (HHS) initiative known as the “Regulatory Sprint to Coordinated Care” in 2018, HHS asked industry stakeholders for information regarding how it can improve both the...more

Mintz - Health Care Viewpoints

Opioids Have Our Attention

The government is focusing on opioids. Whether it be program policies, enforcement, or legislation, combating the opioid epidemic continues to be a major focus for government officials. It is also a major piece of the...more

Bradley Arant Boult Cummings LLP

2017 – The Health Law Year in Review

Uncertain. What better word to describe a year in which a new administration came to power and began to chart a new course for health policy, the fate of the Affordable Care Act (ACA) hung in the balance, and courts grappled...more

Mintz - Health Care Viewpoints

Health Care Weekly Preview from ML Strategies – November 2017

Following House passage of a CHIP reauthorization package, the bill heads to the Senate where it faces an uncertain path forward. First, there’s no indication the Senate is ready to give the House package real consideration....more

Epstein Becker & Green

Health Care Reform 2017: Substance, Process, and Timeline

Epstein Becker & Green on

President-elect Donald J. Trump campaigned on a promise to “repeal and replace” the Affordable Care Act (“ACA”). For several years, the newly reelected Republican majority in Congress has likewise identified ACA repeal as a...more

Mintz - Health Care Viewpoints

Promise to Repeal the ACA Poses Threat to MACRA Implementation

Most of the post-election discussion of the ACA has focused on how promises to repeal the law could impact the newly insured. But one priority area of the ACA that has received very little discussion is the federal...more

Troutman Pepper Locke

The New Era of Health Care Reform

Troutman Pepper Locke on

Welcome to the inaugural edition of The New Era of Health Care Reform which highlights important developments in health care reform under the Trump Administration. A FIRST LOOK AT HEALTH CARE PRIORITIES OF...more

McDermott Will & Emery

Briefing Points for the Board: The Election and the 2017 Health Policy Agenda

McDermott Will & Emery on

It is vitally important for the health system board, as well as certain of its key committees, to receive an introductory briefing as soon as possible on the health policy implications of last week’s Presidential and...more

Mintz - Health Care Viewpoints

The Health Policy Commission’s Annual Cost Trends Hearings

The Massachusetts Health Policy Commission conducted its fourth annual Cost Trends Hearing on October 17 and 18, 2016, under the requirements of Massachusetts’s 2012 health care reform legislation (“Chapter 224”). The hearing...more

Baker Donelson

Senate Finance Committee Report Concludes Stark Law Change Is Necessary to Drive Health Care Reform

Baker Donelson on

In its report, Why Stark, Why Now? [PDF], released June 30, 2016, the Senate Committee on Finance outlines suggested changes to the physician self-referral law, 42 U.S.C. § 1395nn, (the Stark law) in order to facilitate and...more

Foley & Lardner LLP

Health Care IT Program Discusses Alternative Payment Model Opportunities

Foley & Lardner LLP on

A distinguished panel of providers, consultants and IT firms convened on Tuesday, June 21st in New York at the Foley and Lardner LLP offices to share a discussion focused on the convergence of IT spend and new value based...more

Mintz - Health Care Viewpoints

Massachusetts Health Care Reform – Full Speed Ahead; Health Policy Commission 2015 Cost Trends Report

The Massachusetts Health Policy Commission (HPC) has issued its 2015 Cost Trends Report, based on the HPC’s annual health care cost growth hearings. The report contained 13 key recommendations across a wide range of health...more

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