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3 / 18 / 2026

The New Long-Term Enhanced ACO Design (LEAD) Model

By Jennifer Methax & William Cevallos
Effect on Risk Adjustment  The new Long-term Enhanced Accountable Care Organization Design Model (LEAD) will launch January 1, 2027, and will replace the current ACO REACH Model. These new standards...
3 / 11 / 2026

A Look Ahead at the 2027 Ambulatory Specialty Model (ASM)

By Michelle Henry
While 2026 is barely underway, focus is already shifting to January 1, 2027, when the new Ambulatory Specialty Model (ASM) will take effect. The new model is designed to assess...
3 / 4 / 2026

Protecting Margin in CMS TEAM: A Focus on Implant & Instrumentation Strategy

By John Ossowski & Andrew Arreola
Introduction Under the Transforming Episode Accountability Model (TEAM), the cost of implants and instrumentation is included in a single, bundled payment for a surgical episode. There is no separate reimbursement...
2 / 9 / 2026

The Strategic Importance of ACO Network Management & Monthly Roster Maintenance

By Kelly Conroy & Sheri Rodriguez, EdD(c), MA
White Paper | Series 1: Foundations of Value-Based Performance Purpose of This White Paper The purpose of this white paper is to highlight why Accountable Care Organization (ACO) network management...
2 / 4 / 2026

Day 29: Managing the Rapidly Changing Landscape of Independent Radiology Practice Relationships and Health Systems

By Christopher Fete & Jim Yanci
Article originally published through the American Association of Provider Compensation Professionals (AAPCP). Introduction There is a classic riddle that applies to change. A lily pad appears in a pond one day....
1 / 29 / 2026

LEAD, MSSP & the Next Phase of Medicare Accountable Care

By Daniela Yusufbekova
Introduction The Centers of Medicare & Medicaid Services’ (CMS) new Long-term Enhanced ACO Design (LEAD) Model marks a clear inflection point in Medicare accountable care. More than a successor to...
1 / 14 / 2026

Diabetes Coding Updates

By Dawnelle Sager
Over the past two years, ICD-10-CM has introduced several important code updates and additions related to diabetes. In fiscal year (FY) 2025 (effective October 1, 2024), new codes were established...
12 / 17 / 2025

CMS Reduces Inpatient Physician Reimbursement in 2026

By Lucas Hutchison & Jason Baldwin
CMS Fee Schedule Changes for 2026 Centers for Medicare and Medicaid Services (CMS) has finalized the physician fee schedule (PFS) and dealt a significant reimbursement blow to inpatient physician reimbursement....
11 / 7 / 2025

Who Gets Credit? Physician Oversight Value ‘Incident To’ & Split/Shared Billing Models

By Kelly Loya & Carey Lowe-Curry
Article originally published through the American Association of Provider Compensation Professionals (AAPCP). Introduction Healthcare practices increasingly employ teams of non-physician practitioners (NPPs) (such as nurse practitioners, physician assistants) to extend...
10 / 7 / 2025

PHC 2025 Real Estate Newsletter

By Mike Vandaveer
Healthcare Real Estate Transactions Parkview Health to Build 30-bed Hospital in Lebanon, IN. Parkview Health announced plans to build a full-service hospital and medical office building in Lebanon. The facility is...