Bundled Payments

CMS is accelerating mandatory episode-based payment under the Trump administration, finalizing the FY 2026 IPPS/LTCH rule with a revived mandatory CJR-X joint replacement model and related hospital payment updates, while TEAM participants prepare for mandatory downside risk beginning January 1, 2027. The strategic center of gravity is shifting from voluntary bundled-payment experimentation to enterprise-level readiness—governance, gainsharing infrastructure, specialist alignment, post-acute network management, and episode analytics—as hospitals such as UCHealth invest in surgical performance capabilities for TEAM. For VBC leaders, the key tension is whether mandatory bundles become a scalable bridge between fee-for-service and accountable care or a margin-risk accelerant for hospitals already facing cost pressure under fixed episode targets. CMS finalizes hospital pay bump and joint replacement model TEAM readiness and value-based enterprise strategy