The Value Signal — September 25, 2026

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Executive Summary

Medicare's payment plumbing is being re-engineered on several fronts at once, and the early signals point to margin pressure before any promised efficiency arrives.

On Star Ratings, Wakely finds that the 2027 Medicare Advantage Draft Technical Notes, released with the Second Plan Preview, point to a difficult outlook for plans: more measure-level cut points rose than fell, yet reward-factor thresholds dropped at both the 65th and 85th percentiles, a combination Wakely warns could still translate into lower 2028 revenue. On Healthcare Affordability, Healthcare Dive reports that CMS Administrator Dr. Mehmet Oz expects AI to "turbocharge" medical billing and raise costs in the near term, a cost he argues is worth bearing for long-term savings. That is an uncomfortable admission for risk-bearing entities already absorbing coding intensity.

On Medicare physician payment, Schaeffer Usc highlights Paul Ginsburg's view that a bipartisan plan to overhaul physician pay represents "major" reform, while Milbank Memorial Fund has submitted a formal comment on the proposed Physician Fee Schedule change. The result is a fee-for-service baseline that is itself in motion. On Medicaid, Nashp details how states in its Policy Academy are strengthening children's and youth behavioral health by expanding services, supporting providers, and improving care coordination. That is a population where integrated, accountable models have clear room to prove their value.