Alternative payment models

Federal Health Policy Update for March 19

The following is the latest health policy news from the federal government for March 13-19. Some of the language used below is taken directly from government documents. The White House President Trump has issued an executive order creating a Task Force to Eliminate Fraud that “…shall, on behalf of the President, coordinate and accelerate a comprehensive national strategy to stop fraud, waste, and abuse within Federal benefit programs, including programs administered jointly with State, local, tribal, and territorial partners.” The vice president will chair the task force, the Secretary of the Department of Health and Human Services is among its [...]

joe2026-03-19T15:41:48-04:00March 19, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

CMS Will Continue Rolling Out Mandatory Models

The Centers for Medicare & Medicaid Services and its Center for Medicare and Medicaid Innovation intend to continue developing and introducing mandatory Medicare models with an emphasis on driving more value-based care. That is the message delivered by CMS administrator Mehmet Oz and CMMI director Abe Sutton during a recent conference. While the track record of CMMI’s models – both voluntary and mandatory – is not great, policymakers believe they remain the best way for government to continue encouraging health care providers to focus more on the delivery of value-based care. To date, only four of the agency’s approximately 50 [...]

joe2026-03-05T17:04:15-05:00March 10, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare|

Federal Health Policy Update for March 5

The following is the latest health policy news from the federal government for February 27-March 6. Some of the language used below is taken directly from government documents. Congress On Thursday, the House Energy and Commerce Committee held a full committee markup of nine bills addressing cybersecurity and digital safety. See that list here. Also on Thursday, the Senate HELP Committee conducted a hearing titled “Transforming Health Care with Data: Improving Patient Outcomes Through Next-Generation Care.” Find video of the hearing here. Speaker Mike Johnson (R-LA) expressed interest in passing another reconciliation bill this year that would include policies addressing [...]

sysadmin2026-03-06T15:58:46-05:00March 6, 2026|ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicaid regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for February 19

The following is the latest health policy news from the federal government for February 13-19. Some of the language used below is taken directly from government documents. Congress Congress is not in session this week and will return on Monday, February 23. The House Ways and Means Committee will hold a hearing titled “Next Generation of Health Care Workforce” on Tuesday, February 24. View a livestream of the hearing here. The Courts A federal court has vacated the Federal Trade Commission’s (FTC) 2024 overhaul of the Hart-Scott-Rodino Premerger Notification Rule. That rule expanded disclosure requirements, requiring filings for transactions valued [...]

joe2026-02-19T15:40:16-05:00February 19, 2026|340b, Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicare, Medicare regulations|

Federal Health Policy Update for December 29

The following is the latest health policy news from the federal government for December 19–December 29. Some of the language used below is taken directly from government documents. Rural Health Transformation Fund CMS announced that all 50 states will receive awards under the Rural Health Transformation Program, a $50 billion initiative established under the 2025 reconciliation bill, H.R. 1, to strengthen and modernize health care in rural communities. In 2026, states will receive first-year awards averaging $200 million, ranging from $147 million to $281 million. The Rural Health Transformation Program’s $50 billion in funds will be allocated to approved states [...]

sysadmin2026-01-03T11:47:43-05:00December 29, 2025|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for December 18

The following is the latest health policy news from the federal government for December 12-18. Some of the language used below is taken directly from government documents. Congress In a 216-211 vote yesterday, the House passed the Lower Health Care Premiums for All Americans Act, a Republican package aimed at addressing multiple health care policies. The legislation includes provisions for employee tax-advantaged benefits like HSAs and FSAs, cost-sharing reductions (CSR) subsidies, and increased transparency requirements for pharmacy benefit managers (PBMs). It notably did not include an extension of the enhanced Affordable Care Act premium tax credits that many of the [...]

joe2025-12-18T16:29:43-05:00December 18, 2025|Accountable Care Organization, ACO, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for December 11

The following is the latest health policy news from the federal government for December 5-11. Some of the language used below is taken directly from government documents. Congress The Senate voted today on competing proposals to address health care affordability: Democrats sought a clean extension of the Affordable Care Act premium tax credits set to expire on December 31 while Republicans tried to consolidate support around an alternative plan. Neither bill gained the 60-vote threshold needed for passage. In the House, Speaker Mike Johnson (R-LA) intends to bring a vote on a health care package next week but at this [...]

joe2025-12-11T15:48:53-05:00December 11, 2025|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Medicare, Medicaid Regulations Logjam Should Soon End

The shutdown of the federal government brought the usual flow of Medicare and Medicaid regulations to an almost complete halt. Now that the shutdown has ended, the logjam should end fairly quickly – and with a sense of urgency. Currently, a number of major Medicare and Medicaid regulations remain with the Office of Management and Budget for review. Even though the shutdown has now ended, it is not yet clear when they will be addressed. By statute, the following regulations must be implemented by January 1. CY 2026 Hospital Outpatient Prospective Payment System Policy Changes and Payment Rates and Ambulatory [...]

joe2025-11-13T17:00:30-05:00November 18, 2025|Alternative payment models, Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for November 13

The following is the latest health policy news from the federal government for November 7-13. Some of the language used below is taken directly from government documents. Please note that during the federal government shutdown, most HHS and other health care-related agencies, with limited exceptions, engaged in little public activity such as announcements, the publication of new regulations, and updating their web sites. Now that the shutdown has ended, normal activity can be expected to resume shortly. The End of the Federal Government Shutdown On Wednesday night the House passed the Senate-amended version of the continuing resolution (CR) in a [...]

joe2025-11-13T15:20:05-05:00November 13, 2025|Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for November 6

The following is the latest health policy news from the federal government for October 31 – November 6. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown; some are engaging in limited exceptions. Congress and the Shutdown Senate Majority Leader John Thune (R-SD) today told his caucus that he plans to bring the House-passed CR to yet another vote in the Senate on [...]

joe2025-11-06T21:35:12-05:00November 6, 2025|340b, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|