Benchmarking & Attribution
Expert articles and analysis related to benchmarking & attribution.
AI Summary — Last 7 Days
Benchmarking and attribution pressures are converging across Medicare risk: shared-savings ACOs face renewed criticism that benchmark design and attribution have not reliably strengthened primary care, while Medicare Advantage scrutiny is intensifying around risk adjustment, coding incentives, and plan pullbacks that could disrupt attribution continuity for roughly 1 million UnitedHealthcare and Humana members. At the same time, CMS’s finalized CJR-X episode accountability model extends 90-day hospital accountability for joint replacement, reinforcing a Trump administration direction toward tighter episode-based benchmarks and provider accountability across settings. For ACOs, MA plans, and health systems, the near-term strategic issue is no longer just participation in VBC, but whether attribution rules, benchmark rebasing, and risk-adjustment policy will leave enough predictable economics to support longitudinal care management and primary-care investment (NEJM on shared-savings ACOs; CJR-X final analysis).
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Why Shared-Savings ACOs Have Failed to Deliver for Primary Care
New England Journal of Medicine, Ahead of Print.
As Medicare Advantage options shrink, Minnesota is hit hard
The MA pullback comes amid a federal crackdown on suspected Medicaid fraud in Minnesota.
UnitedHealthcare, Humana Medicare Advantage cancellations to affect 1 million
UnitedHealthcare, Humana Medicare Advantage cancellations to affect 1 million  The Hill
Molina joins Medicaid recovery bandwagon despite mixed Q3
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CJR-X Is Final: Is Your Hospital Ready for 90 Days of Accountability?
In June, I wrote about the proposed Comprehensive Care for Joint Replacement Expanded (CJR-X) Model and its relationship to the Transforming Episode Accountability Model (TEAM). At that time, the disc...