Access to Care

Access pressure is surfacing across both federal payment design and site-of-care rules: CMMI’s ACCESS model is being framed under the Trump administration’s “Make America Healthy Again” Innovation Center agenda as a chronic-care, prevention, patient-choice, and taxpayer-protection model, while provider-facing reports warn that CMS audit interpretations could restrict post-surgical SNF rehab access as CJR-style episode payment returns (ACCESS model overview; SNF rehab/CJR concerns).

For VBC leaders, the week’s pattern is a widening gap between “access-expanding” delivery strategies—rural telehealth, Alaska primary care network partnerships, HCBS wait-list legislation, and heart-failure workflow enablement for ACCESS participation—and operational/policy constraints that could shift risk onto ACOs, MA plans, hospitals, and conveners if access metrics, documentation, and post-acute pathways are not tightly managed.