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  • CMS ACCESS Model: A Provider & Hospital Playbook

    As CMS launches the ACCESS initiative, providers should not miss out on the revenue their participating patients generate. There is money on the table — both today and tomorrow. This playbook walks through how participation sets providers up for value-based contracting success, eligibility for the rural health initiative, improved MIPS performance, and more. Download the…

  • Beyond the Framework: What 30 Years of Maternity Program Work Tells Us We Still Need to Do

    Commentary by Cassandra Toscano, MBA Co-Founder, Principal Advisor & CEO, Health Transformation Advisor As someone who has launched maternity programs across nearly half the states in a 30-year career, the recent NEJM Catalyst article on payer strategies to improve maternal health care resonates deeply — and leaves me with a lot more to say. The…

  • Accountable Health Communities Model Final Evaluation Findings

    AHC Generated More Than $200 Million in Net Savings The AHC Model reduced expenditures. Almost 80% of the total savings were among Medicaid-only beneficiaries, which represented about 70% of AHC beneficiaries. We put so many social needs like food assistance and housing through the health system and payers, reasonably, will pay for and support these…

  • What is the Rural Health Transformation Program?

    The Rural Health Transformation Program (RHTP) represents a once-in-a-generation $50 billion federal investment in local health infrastructure, with 50 states participating and funding flowing from 2026 through 2030. This article breaks down what the program is, how states are implementing it, and what rural providers need to know about participating — including mandatory provider partnership…

  • Accountable Health Communities (AHC) Model

    AHC Generated More Than $200 Million in Net Savings The AHC Model reduced expenditures. Almost 80% of the total savings were among Medicaid-only beneficiaries, which represented about 70% of AHC beneficiaries. We put so many social needs like food assistance and housing through the health system and payers, reasonably, will pay for and support these…

  • Leaders at NAACOS 2026 Discuss Clinical AI

    At the national NAACOS meeting this Spring, health system leaders discussed current use cases for AI in their organizations. Their comments are in line with HTA’s assessment on areas of focus, including chronic illness, patient-facing apps, and reducing administrative burden. They also highlight the same data fragmentation issue as was discussed in our episode 1 on Clinical…

  • Long-Term Enhanced ACO Design (LEAD) Model Executive Summary

    CMMI’s Next-Generation Accountable Care Program Performance Period: January 2027 – December 2036   Program Overview On December 18, 2025, the Centers for Medicare & Medicaid Services Innovation Center (CMMI) officially announced the Long-term Enhanced ACO Design (LEAD) Model — a landmark voluntary accountable care initiative that will succeed the ACO REACH program when it concludes…

  • Capturing the $50B Rural Health Transformation Opportunity

    Strategic Advisory & Program Execution Support for Provider Organizations Federal and state governments are launching one of the largest investments ever in rural healthcare through the Rural Health Transformation Program (RHTP), allocating $50B to expand access, modernize care delivery, and improve health outcomes in underserved communities. For many rural hospitals, physician groups, and health systems,…

  • Extracting Value from Clinical AI Use Cases, Episode 1

    TLDR Summary Clinical AI implementation must be substantive rather than additive to avoid overwhelming an already stressed healthcare system AI training requires whole language processing and training on millions of clinical conversations to be accurate and effective Healthcare infrastructure challenges (fragmented data, provider leakage, lack of interoperability) must be addressed for AI to deliver value…

  • Prior Authorization and Associated Delays and Denials of Branded Medication Dispensation

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