Why It Matters
GuideStar Eldercare LLC has initiated federal lobbying for long-term care policy. The company, which provides medical and behavioral health clinicians to nursing facilities, engaged Loper Consulting LLC to advocate on Centers for Medicare & Medicaid Innovation (CMMI) models as Congress and CMS implement alternative payment structures.
The timing reflects converging policy trends:
- CMMI model expansion: CMS announced three new models launching in 2026-2027, including the TEAM and ACCESS models, establishing value-based reimbursement pathways.
- Regulatory shifts: Following the December 2025 repeal of minimum staffing requirements, providers are navigating cost structures related to integrated care models.
- Congressional activity: Bipartisan legislation to extend Advanced APM incentive payments signals continued focus on value-based care.
By the Numbers
GuideStar filed its first federal lobbying registration in 2025, naming Loper Consulting as its representative. Virginia Gregory Loper serves as the principal lobbyist, with over two decades of healthcare policy experience and 73 disclosures for the American Medical Association on Medicare payment reform.
Loper Consulting has reported approximately $5.3 million in lobbying revenue across 171 disclosures since its inception. The firm’s client list includes healthcare entities like Teva Pharmaceuticals USA Inc. and Clover Health LLC.
The Agenda
GuideStar’s advocacy focuses on CMMI models related to integrated medical, psychiatric, and behavioral health services in long-term care settings. While the filings do not specify individual bills, current legislative activity in this sector includes:
- Health Care Efficiency Through Flexibility Act (H.R. 483): Proposes a delay for mandatory electronic quality reporting for ACOs until 2030.
- Caring for Seniors Act (H.R. 3000): Promotes alternatives to institutional nursing care.
- Protecting Rural Seniors’ Access to Care Act (S. 750): Concerns the limitation of federal minimum staffing mandates.
GuideStar’s activity coincides with CMS’s launch of new CMMI models in 2026, which provide reimbursement pathways for integrated care in value-based arrangements.
Broader Context
The long-term care sector is responding to the December 2025 repeal of federal minimum staffing requirements and legislative discussions regarding Medicaid funding levels. Simultaneously, CMS is transitioning toward alternative payment models through CMMI, with new episode-based models scheduled for 2026 that establish reimbursement pathways based on clinical outcomes. Federal policy has expanded to include specific dementia care initiatives and the integration of behavioral health into standard Medicare payment models.
Between The Lines
Legislative and regulatory activity directly impacts GuideStar’s operational environment. In March 2025, The House Ways and Means Health Subcommittee held hearings on post-acute care access, focusing on staffing levels and reimbursement sustainability. Additionally, representatives introduced legislation extending APM incentive payments.
Member communications further outline perspectives on sector funding and structure. Rep. Brian Fitzpatrick stated that value-based models improve patient outcomes and save Medicare money. Separately, Rep. Bernie Sanders stated that proposed cuts to Medicaid and the Affordable Care Act could lead to long-term care facility closures or downsizing.
Competitive Landscape
GuideStar operates alongside other organizations advocating on long-term care and Medicare reimbursement policy:
- Coalition of Long Term Acute Care Hospitals: Focuses on Medicare payment policy for long-term acute care settings.
- Access to Part B Services for LTC Residents Coalition: Addresses Medicare Part B payment issues in long-term care.
- Direct Supply Inc.: Lobbies on long-term care reimbursement and Medicare funding adjustments.
The engagement of Loper Consulting establishes GuideStar’s presence among these entities within federal healthcare policy discussions.
The Bottom Line
GuideStar initiated federal lobbying in 2025 to participate in the development of CMMI reimbursement structures for integrated behavioral health services. By engaging Virginia Gregory Loper, the organization is seeking to navigate the implementation of new value-based payment models. This activity aligns GuideStar’s service delivery with federal efforts to manage post-acute care costs and clinical outcomes through alternative payment models.
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