Bundled Episode Payments
Expert articles and analysis related to bundled episode payments.
AI Summary — Last 30 Days
CMS is moving bundled episode payments toward a broader mandatory-model posture under the Trump administration, with stakeholders focused on the FY 2027 IPPS/LTCH PPS rule’s implications for TEAM and the proposed Comprehensive Care for Joint Replacement Expanded model (CJR-X). Hospital, ACO, and purchaser groups are pressing CMS to recalibrate target pricing, quality measures, risk adjustment, and overlap rules—reflecting concern that mandatory episode models could accelerate VBC adoption but also magnify hospital underpayment and specialist-alignment risk if benchmarks are too aggressive. The strategic signal for VBC leaders is to build episode-level analytics, post-acute management, and physician gainsharing infrastructure now, as CJR-X and TEAM are becoming central tests of whether CMS can scale mandatory bundles without destabilizing provider participation (Premier comments; Forvis Mazars on CJR-X).
Related Articles
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AHA recommends changes to CMS’ mandatory payment model for joint replacement procedures
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Proposed implementation of the Comprehensive Care for Joint Replacement Expanded model - MedPAC (.gov)
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