The Value Signal — June 13, 2026

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Executive Summary

Washington is tightening the value-based care perimeter: prior authorization, waivers, model funding and drug pricing are all being pulled toward harder federal rules and measurable accountability.

Utilization management and federal oversight are now the immediate flashpoint: MedCity News reports that the three largest Medicare Advantage insurers denied prior authorization requests for long-term acute care and inpatient rehabilitation at higher rates than other MA plans in 2024, while Premier says it urged CMS to modernize prior authorization and interoperability requirements across federal health programs. Healthcare Finance News reports that the House Appropriations Committee voted to end funding for the WISeR pilot, underscoring congressional resistance to CMS payment-control experiments even as Fierce Healthcare reports that CMS proposed a permanent framework for Medicare drug price negotiations.

Medicaid, post-acute care and VBC execution are moving into a more disciplined operating cycle: Home Health Care News reports that CMS is taking “bold” action to make Medicaid Section 1115 waivers budget-neutral, while Health Affairs challenges ASPE’s analysis of Medicaid work requirements as resting on assumption-heavy arguments. Hooper, Lundy & Bookman reports that California adopted first-ever hospice licensing regulations, Forvis Mazars highlights data-driven strategy as central to CJR-X performance, and AMA says robust clinical teaming is the “secret sauce” for delivering value-based care.