Blog
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. […]
Rural Health Transformation in New York: What Federal Funding Means for Rural Providers, Hospitals, and FQHCs
January 14, 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 14, 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 […]
Federal Healthcare Policy Updates: Planning for Success in 2026-2027
January 14, 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 […]
Using Data to Win at MSSP
August 14, 2025“People who run ball clubs, they think in terms of buying players. Your goal shouldn’t be to buy players, your goal should be to buy wins. And in order to buy wins, you need to buy runs. You’re trying to replace Johnny Damon. The Boston Red Sox see Johnny Damon and they see a star […]
How We See CalAIM Impacting Maternal Health Organizations
August 13, 2025Providing equitable maternal health care is of growing interest across the nation. Disparities in access to maternal health services, including prenatal, perinatal, and postpartum care that meet the unique needs of various populations disproportionately impact Black, Indigenous, and other communities of color, leading to poor maternal health outcomes. For example, Black women are 2-3 times […]
Transforming Complex Care: Driving Outcomes and Reducing Costs with Care at Home Solutions
August 13, 2025I. Executive Summary: Care at Home Solutions is an innovative, community-based program designed by COPE Health Solutions to support high-risk, medically complex patients where they feel safest, at home. Through a physician-led, multidisciplinary care team, we aim to improve outcomes, reduce avoidable utilization, and restore connections to ongoing care. II. The Problem: Gaps in […]
Thriving Through Transition: How Value-Based Care Can Help Healthcare Providers Navigate Medicaid Cuts and Policy Shifts
August 13, 2025As federal policy evolves, healthcare providers serving Medicaid populations are bracing for intensified financial strain. H.R. 1 will impact Medicaid eligibility and financing, with an expected increase in the uninsured population and decrease in federal health care spending. These changes will place immense pressure on providers to maintain care quality with diminished resources. The […]
Why Most FQHC Strategic Plans Fail—and How to Build One That Delivers
July 30, 2025Strategic planning has always been a requirement for Federally Qualified Health Centers (FQHCs). In today’s rapidly evolving market, the right strategic plan—centered on value-based payment (VBP) and value-based care—is also a competitive differentiator. CMS is accelerating the shift to VBP, and managed care plans are becoming more selective with their partnerships. FQHCs that treat strategic […]
Prior Authorization Change for Traditional Medicare
July 17, 2025What Happened?: In early July, CMS announced that they will be launching a new technology focused prior authorization process in six states to help combat fraud, waste and abuse in Traditional Medicare. CMS has highlighted that fraudulent or abusive billing practices, the provision of services with minimal clinical benefit and the use of riskier […]