Alternative Payment Models
Expert articles and analysis related to alternative payment models.
AI Summary — Last 30 Days
CMS is widening the alternative payment model pipeline under the Trump administration, with CMMI’s new 10-year LEAD ACO model positioning accountable care as a longer-duration infrastructure bet while giving ACOs until May 17, 2026 to decide whether to enter a model designed to broaden participation beyond current MSSP-style capabilities (Wakely). At the same time, CMS is leaning harder into mandatory and specialty-specific models—CJR-X, TEAM, heart failure payment reforms, ACCESS/TEMPO technology-enabled care, and changes to the Increasing Organ Transplant Access Model—signaling that VBC strategy is moving from optional experimentation toward more compulsory, data-enabled, condition- and episode-based accountability. For health systems, ACOs, and payers, the strategic tension is whether to build enterprise-wide population health, analytics, specialist alignment, and post-acute management capabilities now, or risk being pulled into mandatory models with weaker infrastructure and less control over downside-risk performance.
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