Provider Consolidation, Bundled Payments, MA Overpayments, and More!

Lawmakers Scrutinize Provider Consolidation

On March 18, 2026, the House Energy and Commerce Committee’s Subcommittee on Health held its third hearing in an ongoing series on healthcare affordability, titled “Lowering Health Care Costs for All Americans: An Examination of the U.S. Provider Landscape.” This Health Capital Topics article examines the key themes that emerged from the hearing, including the ongoing decline of independent physician practice, legislative approaches to Medicare physician payment reform, and the intensifying bipartisan scrutiny of hospital consolidation. (Read more...)

Study Questions Sustainability of Voluntary
Bundled Payments

A study published in the February 2026 issue of Health Affairs has provided the most comprehensive peer-reviewed evidence to date that voluntary bundled payment models are unlikely to generate meaningful or sustained savings for the Centers for Medicare & Medicaid Services (CMS). The findings arrive at a pivotal moment for Medicare payment policy, as CMS recently launched its new mandatory Transforming Episode Accountability Model (TEAM) and the CMS Innovation Center has signaled an increasing commitment to mandatory model designs. This Health Capital Topics article examines the study’s key findings, implications for mandatory versus voluntary payment models, and the broader landscape of alternative payment model (APM) adoption. (Read more...)

Medicare Advantage Overpayments
Under the Microscope

The Medicare Advantage (MA) program has grown to cover over 55% of eligible Medicare beneficiaries, with approximately 34.9 million enrollees in 2025 and 5,492 plan options offered by 164 organizations. As MA’s market share has expanded, so too has the federal government’s financial exposure. This Health Capital Topics article examines the sources of these excess payments, the regulatory and enforcement landscape, and the powerful industry lobbying apparatus that may complicate efforts to address them. (Read more...)

Valuation of Orthopedic Services: Reimbursement

As discussed in the second installment of this five-part Health Capital Topics series regarding the valuation of orthopedic services, the competitive environment for orthopedic services is characterized by growing demand and constrained supply. This third installment examines the reimbursement environment for orthopedic services, including the Medicare Physician Fee Schedule (MPFS), recent legislative changes affecting physician reimbursement, and the emergence of value-based payment models relevant to orthopedics. (Read more...)

NEW ARTICLE!

HCC's Jessica Bailey-Wheaton and Hannah Newman of Hancock Daniel were recently published in the American Bar Association's The Health Lawyer. Their article entitled “External Expertise in Physician Compensation: A Smart Investment” explores why partnering with independent valuation and compensation specialists is no longer optional for many organizations. From navigating FMV and commercial reasonableness standards to structuring performance-driven, value-aligned models, external advisors bring objectivity, rigor, and proven experience to an increasingly high-stakes environment.

For more recently published material written by HCC, please visit www.healthcapital.com

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