Fifth Circuit Vacates No Surprises Act Payment Methodology

On August 11, 2026, the U.S. Court of Appeals for the Fifth Circuit, sitting en banc, vacated central portions of the federal rules governing how health insurers calculate the “qualifying payment amount” (QPA) under the No Surprises Act (NSA). The decision in Texas Medical Association v. U.S. Department of Health and Human Services (TMA III) is the latest in a string of provider victories reshaping the NSA’s out-of-network payment framework. This Health Capital Topics article reviews the statutory framework, the incentives independent dispute resolution (IDR) has unintentionally created, the court’s holdings, and the resulting state of play. (Read more...)

CMS Finalizes Mandatory Nationwide Bundle for Joint Replacement



On July 31, 2026, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) PPS final rule. Alongside a 2.3% increase to IPPS payment rates, the rule finalizes the Comprehensive Care for Joint Replacement Expanded (CJR-X) Model, the first episode-based payment model that Medicare will require most acute care hospitals nationwide to join. Beginning January 1, 2028, CJR-X will hold participating hospitals financially accountable for the cost and quality of lower extremity joint replacement (LEJR) episodes for a period of 90 days beyond discharge. This Health Capital Topics article reviews the finalized model, the revisions CMS made in response to public comment, and the questions the model raises for hospitals and for the physicians and post-acute providers who treat their patients. (Read more...)

Private Equity in Healthcare: Pivot, Not Retreat


Commentary through the first half of 2026 has described private equity as retreating from healthcare. The data supports a narrower conclusion. Investment in physician practice management companies (PPMCs) has fallen sharply from its 2021 peak, but aggregate private equity deal counts and disclosed capital deployed across the industry have both risen year over year. Private equity has not left healthcare. It has instead pivoted away from the leveraged physician roll-up and toward larger, later-stage, and asset-backed targets. This Health Capital Topics article examines past and current private equity activity in healthcare. (Read more...) 

Valuation of Neurology Services: 
Regulatory Environment

The previous installments of this series examined the competitive environment for neurology services and the Medicare reimbursement framework applicable to physician and telehealth services. This installment turns to the regulatory environment, focusing on the two federal fraud and abuse laws that most significantly shape the operation and transaction structures of neurology providers: the Anti-Kickback Statute and the physician self-referral law, commonly known as the Stark Law. This Health Capital Topics article is the third in a four-part series on the valuation of neurology services. (Read more...) 

NEW ARTICLE

Part II of II of the "Urgent Care Centers: Finding Value in the Continuum of Care" series was featured in the recent issue of The Value Examiner, published by the National Association of Certified Valuators and Analysts (NACVA) .

Read Here

If you missed Part I of II, click HERE to read the full article. For more recently published material written by HCC, please visit www.healthcapital.com

HCC will also present a webinar on this topic as part of the NACVA Advanced Learning Series on October 28, 2026.

Register Here

IN CASE YOU MISSED IT

"The Current State of Ambulatory Surgery Centers and Future Trends," authored by HCC's Todd A. Zigrang and Jessica Bailey-Wheaton, as well as Bhagwan Satiani, MD, and Anil Hingorani, MD, will be featured in an upcoming issue of Annals of Vascular Surgery. 


Get an Exclusive 
First Look HERE!