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Provider Network Models

Expert articles and analysis related to provider network models.

199 articles•Last 30 Days

AI Summary — Last 30 Days

CMS is broadening provider-network and payment-model leverage across both Medicare and Medicaid: the 2027 Ambulatory Specialty Model participant list signals continued movement of specialty practices into accountable, episode- or condition-oriented payment, while ACCESS outcome-aligned billing guidance pushes chronic care vendors and provider partners toward measurable longitudinal outcomes rather than fee-for-service activity. At the same time, the Trump administration’s GENEROUS Medicaid drug-pricing model—now with all states applying—creates a parallel affordability lever that could reshape payer-provider pharmacy strategy, formulary alignment, and total-cost-of-care performance in Medicaid risk arrangements (ACC on specialty model participants; [AHA on GENEROUS Model participation](https://news.google.com/rss/articles/CBMizgFBVV95cUxOOWhnN0wxZTRDYWJNSFg1Um0zS2pFMl9JZG5ZYmF6TGZsNjlIUEx6T0tfV29hck5KTm1zb1U4dHhXWDNvaUJMbjNGTmU1WTdmaWwyWjViVng3QUVJdlBCRVNsQ1lZbXhVSmpzSW51cUFBMF9PbUE5U1d3Wm16QmhPQzRqTV

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STAT+: How Trump’s latest pharma deals may undermine efforts to rein in drug costs

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Administration announces a new set of drug pricing agreements

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Three takeaways from Trump's latest drug pricing event

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Midsized Biotechs Strike MFN Drug Pricing Deals

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Trump strikes Medicaid drug price deals with pharma firms

Trump strikes Medicaid drug price deals with pharma firms  Modern Healthcare

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Trump announces nine new MFN drug pricing deals

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Trump strikes nine more deals with drugmakers to lower prices

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90ALN

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90ALN

AHA Pushes Back Against Sen. Cassidy’s 340B Proposals

AHA Pushes Back Against Sen. Cassidy’s 340B Proposals  HealthLeaders Media

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