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ACA Subsidy Extension Update
As discussed in prior Health Capital Topics articles, the enhanced Affordable Care Act (ACA) premium tax credits expired on December 31, 2025, after Congress failed to pass extension legislation before the year-end deadline. In the weeks since expiration, the U.S. House of Representatives passed a three-year extension bill, President Trump unveiled a competing healthcare framework dubbed “The Great Healthcare Plan,” and congressional leaders announced a bipartisan funding deal that notably excludes ACA subsidy provisions. This Health Capital Topics article provides an update on the current status of legislative efforts, the Trump Administration’s proposed plan, enrollment impacts, and implications for healthcare providers. (Read more...)
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CMS Innovation Center Announces
Six New Payment Models
Between December 2025 and January 2026, the Centers for Medicare & Medicaid Services (CMS) Innovation Center unveiled six new alternative payment models spanning drug pricing, chronic disease management, lifestyle medicine, and accountable care. The models represent a significant expansion of both voluntary and mandatory payment reform initiatives. This Health Capital Topics article discusses the key provisions, reimbursement mechanisms, and participation requirements of each model. (Read more...)
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DOJ Reports Record $6.8 Billion in
False Claims Act Recoveries
On January 16, 2026, the Department of Justice (DOJ) announced that False Claims Act (FCA) settlements and judgments topped $6.8 billion in fiscal year (FY) 2025, which ended September 30, 2025. This figure marks the largest single-year recovery since the FCA was enacted. The government also opened 401 new investigations. Cumulative FCA settlements and judgments since 1986, when Congress significantly strengthened the statute, now surpass $85 billion. The FY 2025 recoveries represent a substantial jump from the $2.9 billion collected in FY 2024 and the $2.68 billion collected in FY 2023. (Read more...)
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Valuation of Orthopedic Services: Introduction
This five-part Health Capital Topics series provides a discussion of current trends in the orthopedic surgery industry relevant to the valuation of orthopedic services. This series discusses the competitive, reimbursement, regulatory, and technological environments in which these providers operate, as well as the implications of these trends for the orthopedic surgery industry. This first installment provides an overview of orthopedic surgery and the burden of musculoskeletal diseases and injuries that drive demand for orthopedic services. (Read more...)
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"Valuation of Care Coordination Services Part I of II" authored by HCC President, Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA, ABV, and, HCC Senior Vice President and General Counsel, Jessica Bailey-Wheaton, Esq., was featured in the recent issue of The Value Examiner, published by the National Association of Certified Valuators and Analysts (NACVA) .
For more recently published material written by HCC, please visit www.healthcapital.com
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The 14th edition of our annual Health Capital Topics eBook is HERE! We invite you to download and explore HCC's insights on key issues in the dynamic U.S. healthcare industry and their potential impact on healthcare organizations and services.
As always, we appreciate the many comments and expressions of support for this research endeavor. HCC’s research is the foundation for all of our client engagements and firm as a whole. For any inquiries, please do not hesitate to email us at solutions@healthcapital.com or call us at 800-FYI-VALU.
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