Literature Review

Global adoption of value-based health care initiatives within health systems-A scoping reviewJAMA Health Forum; Ayooluwa O. Douglas, MD, MPH; Senthujan Senkaiahliyan, MHSc; Caroline A. Bulstra, DVM, MHSc, PhD; Carol Mita, MS; Che L. Reddy, MBChB, MPH; Rifat Atun, MBBS, MBA; 5/25The value-based health care (VBHC) framework was introduced in the US in 2006 to combat rising health care expenditures that failed to produce improvements in patient quality, safety, and outcomes over the past decades. The framework focuses on 6 elements: (1) organizing care around medical conditions, (2) measuring outcomes and costs for every patient, (3) aligning reimbursement with value through bundled payments, (4) integrating care systems regionally, (5) establishing national centers of excellence for complex care, and (6) using information technology systems to support these elements. This scoping review of 50 initiatives found that the implementation of VBHC globally is still in its early stages, with published scientific literature pointing to small-scale institutional-level implementation within individual departments and hospitals. Large-scale implementation designed to develop high-value health systems is limited.

HHS faces $31B cuts in proposed FY ’26 budget: 6 notes Becker's Hospital Review; by Madeline Ashley; 6/2/25 President Donald Trump’s proposed fiscal 2026 budget slashes funding for the National Institutes of Health by $18 billion to $27.5 billion as part of a sweeping overhaul to realign federal healthcare spending.  The NIH received $46.4 billion in program level funding in 2024 and just over $46 billion in 2025, according to the budget proposal. [Continue reading for this article's lists of (1) consolidated institutes and centers; and (2) "six things to know."]

AHA urges HHS to cut regulations that burden hospitals and staff OR Manager; by Matt Danford; 5/16/25 The American Hospital Association (AHA) has called on the Department of Health and Human Services (HHS) to eliminate or ease a variety of federal regulations, arguing that excessive administrative rules drive up costs, reduce patient access, and hinder innovation, Modern Healthcare reported May 13. According to the article, the AHA submitted more than 100 deregulatory suggestions to HHS, the Centers for Medicare and Medicaid Services (CMS), and the Office of Management and Budget. [Continue reading for descriptions specific to billing and payment, quality and safety regulations, and workforce-related recommendations.]

States sue HHS over layoffs, restructuring: 5 updates Becker's Hospital Review; by Madeline Ashley and Mackenzie Bean; 5/5/25 Nineteen states and the District of Columbia filed a lawsuit against the federal government May 5 aiming to block the Trump administration’s large-scale restructuring of HHS. In the lawsuit, New York Attorney General Letitia James and 19 other AGs argue the restructuring is an “unconstitutional and illegal dismantling of the department.” They contend the government has violated hundreds of laws and bypassed congressional authority by enacting the plan, which has erased decades of public health progress and left HHS unable to execute many vital functions.

RFK Jr. is gutting minority health offices across HHS that are key to reducing health disparities NBC New York 4, in partnership with CNBC; by Annika Kim Constantino; 4/30/25 

Administration to close HHS Civil Rights office Newsmax; by Brian Freeman; 4/28/25 As part of massive cutbacks at the Department of Health and Human Services, the Centers for Medicare & Medicaid Services will shut down their civil rights office in June, according to an email sent to staff on Monday and viewed by Politico. HHS has already been reduced by some 20% as part of overall downsizing, with Secretary Robert F. Kennedy Jr. and President Donald Trump focusing on eliminating those programs and agencies they say promote diversity, equity, and inclusion. ... Complaints that are nearing completion connected to workplace harassment and discrimination will be closed out in the coming weeks, and remaining complaints will be "transferred to an appropriate entity," the email stated.Editor's note: Data from the 2024 NHPCO Facts and Figures Report states: "In CY 2022, 51.6% of White Medicare decedents used the Medicare Hospice Benefit. 38.1% of Asian American Medicare decedents and 37.4% of Black Medicare decedents enrolled in hospice. 38.3% of Hispanic and 37.1% of North American Native Medicare decedents used hospice in 2022." The discrepancies between white and non-white decedents demonstrate double-digit differences. Extensive evidence-based research validates wide gaps in hospice/healthcare for persons whom the HHS Civil Rights office is charged with protecting. For more, visit Office of Civi Rights Home | HHS.gov and Office of Civil Rights About Us. 

HHS cuts funding for NIH-based Women's Health Initiative threatening decades-long study The American Journal of Managed Care (AJMC); by Giuliana Grossi; 4/23/25 HHS is defunding the regional research centers that have been conducting a long-term national health study focusing on preventive strategies for women's health since 1991, the largest study investigating women’s health in US history. The Women’s Health Initiative (WHI) regional centers will close by September 2025, at the end of the fiscal year, according to an announcement from the NIH-based initiative. Investigators at the WHI were informed by HHS earlier this week, although formal written notice from HHS is still pending.  

While claiming transparency, CMS quietly drops health equity elements of EOM American Journal of Managed Care (AJMC); by Mary Caffrey; 4/22/25 Key Takeaways:

HHS proposal slashes Medicare SHIP funds MSN; by Mary Helen Gillespie; 4/22/25 The Trump administration is proposing federal budget cuts to Medicare State Health Insurance Assistance Programs (SHIP) and seven additional elder health care safety net programs that assist older Americans. ... SHIP programs have been under the umbrella of the Health and Human Services agency Administration for Community Living. The pre-decisional budget lists funds for seven other ACL programs that would be eliminated are:

Regulatory leaked HHS budget signals $40B in cuts, assumes ACA subsidies expire Fierce Healthcare; by Noah Tong; 4/17/25 Department of Health and Human Services (HHS) reorganization plans appear to have been revealed through a leaked Office of Management and Budget (OMB) document. The 64-page PDF with HHS’ plans were first reported by Inside Medicine and later reported by The Washington Post and other news publications. In an update, Inside Medicine said the entire document was authenticated by The Washington Post. ... While the restructuring was broadly announced, and individual offices have been reportedly axed in recent weeks, the leak provides greater insight into how the reorganization, firings, reductions in force and office eliminations and consolidations will fundamentally alter the agency.

Cybersecurity contracts at risk as HHS cuts 150 IT workers: Report Becker's Health IT; by Naomi Diaz; 4/15/25 The Department of Health and Human Services could face a critical breakdown in its IT and cybersecurity systems after a sweeping reduction in force that eliminated key staff and leadership, Wired reported April 14, citing four current and former agency employees. More than 150 workers in HHS’ Office of the Chief Information Officer were among hundreds of administrative staff laid off April 1, according to the report. These employees were responsible for contract renewals and cybersecurity licenses and oversaw operations at the department’s Computer Security Incident Response Center — the hub for detecting and responding to cyberthreats across the department. Sources told Wired the cuts left no one in place to renew critical cybersecurity contracts, some of which are set to expire as soon as June.

HHS restructuring and workforce reductions – key implications for the health care industry JD Supra; by Mintz.com; 4/15/25 ... As part of the department-wide restructuring plan, HHS is in the process of consolidating 28 different divisions into 15 divisions. As of April 4, 2025, it had also reduced the number of Regional Offices from ten to five. ... 

PACE growth expected to continue amid HHS reorganization, provider uncertainty McKnights Long-Term Care News; by Zee Johnson; 4/15/25 ... Coordination for the PACE program is moving to the Centers for Medicare & Medicaid Services Center for Innovation, the National PACE Association said. That shake up, HHS officials have said, should make management of the PACE program more productive. The White House, however, is also seeking $800 million in budget cuts at CMMI. ... A white paper published in January by Health Dimensions Group showed 33 states and the District of Columbia had implemented 180 PACE programs, accounting for more than 79,000 enrollees. The 25 programs that were added in 2024 quadrupled the model’s average growth since 2005.