Blog
Federal Healthcare Policy Updates: Planning for Success in 2026-2027
January 15, 2026Introduction: Over the last 30 days, CMS and other federal agencies released several major policy and payment model announcements, many of which landed quietly over the holidays. While numerous regulatory updates were issued, three developments stand out as especially consequential for providers nationwide: Announcement of the LEAD ACO Model: Announcement of the ACCESS […]
Rural Health Transformation in New York: What Federal Funding Means for Rural Providers, Hospitals, and FQHCs
January 15, 2026How CMS is Sequencing Rural Health Transformation for Value-Based Care Success The next phase of rural health transformation is not being driven by a single payment model, but by the intentional interaction of multiple CMS initiatives, each designed to address a different barrier to value-based care. On December 29, 2025, the Centers for Medicare & […]
Rural Health Transformation in Texas: What Federal Funding Means for Rural Providers, Hospitals, and FQHCs
January 15, 2026Federal Framework Impacting Texas Transformation: Texas is entering a new era of rural health that will be shaped by the federal Rural Health Transformation (RHT) Program, led by the Centers for Medicare & Medicaid Services (CMS). This program represents the largest coordinated federal investment in the nation’s rural healthcare system to date and is […]
California’s Rural Health Transformation (RHT): From Fragmented Access to Regional Care Networks
January 15, 2026California is undergoing a major shift in how health care is delivered, financed, and sustained for rural communities, driven by state priorities and recent Centers for Medicare & Medicaid Services (CMS) announcements. In December 2025, CMS announced $50 billion in funding through the five-year Rural Health Transformation (RHT) Program, along with ACCESS and LEAD ACO. […]
LEAD ACO Model: Reviving the Promise of PC Flex
December 29, 2025CMS recently announced the Long-term Enhanced ACO Design (LEAD) Model: , positioning it as the follow-up to ACO REACH, which sunsets at the end of 2026. This 10-year voluntary model kicks off January 1, 2027, and promises the longest ACO model yet. LEAD isn’t just a REACH sequel – it is breathing new life into […]
Preparing for OBBA (H.R. 1): How Medi-Cal Plans Can Reduce Attrition and Protect Member Coverage Under New Eligibility Rules
December 29, 2025The One Big Beautiful Bill Act (OBBA) introduces the most significant transformation of Medicaid eligibility since the Affordable Care Act (ACA), placing ACA Expansion Adults at higher risk of coverage loss and exposing large Medi-Cal health plans to $40 to $50 million in annual capitation risk. Beginning December 31, 2026, states must implement six-month redeterminations […]
What You Need to Know About California’s DHCS $145M CITED Awards
December 29, 2025With the release of the California Department of Health Care Services’ (DHCS) fourth and final PATH CITED funding round, $145.5 million were distributed to 153 organizations across all 58 counties in California to further support CalAIM program development. Awards were given to organizations that provide Enhanced Care Management (ECM) and Community Supports services including in-person […]
5 Things to Know About California’s Medicaid Waiver Renewal
November 17, 2025California’s CalAIM (California Advancing and Innovating Medi-Cal) initiative is approaching a pivotal milestone as its federal waiver is set to expire at the end of 2026. Launched in January 2022 under a Section 1115 demonstration waiver, CalAIM represents a major reform effort aimed at transforming how Medi-Cal serves its most vulnerable populations. Operated by the […]
A 5-Step Framework to Improve Your Health Plan’s Star Rating
October 15, 2025Introduction: The National Committee for Quality Assurance (NCQA) Health Plan Ratings and Centers for Medicare & Medicaid Services (CMS) Star Ratings each serve as highly influential measures of health plan quality performance nationwide. These ratings serve as meaningful indicators of how well plans deliver high-quality, patient-centered care, providing consumers, employers, and policymakers with a […]
$50B Rural Health Transformation Opportunity: What FQHCs and Rural Providers Need to Know
October 9, 2025The One Big Beautiful Bill Act, signed into law earlier this summer, created the Rural Health Transformation (RHT) Program: , an initiative launched by the Centers for Medicare & Medicaid Services (CMS) to help rural communities redesign their healthcare delivery systems, expand access to quality care, develop the workforce, and improve health outcomes through innovation […]