Care Delivery Innovation
Expert articles and analysis related to care delivery innovation.
AI Summary — Last 7 Days
CMS is tightening Medicaid fiscal guardrails under the Trump administration, including new scrutiny of Section 1115 waiver budget neutrality and broader program-integrity actions, signaling that state Medicaid innovation strategies—including home- and community-based services expansions—will face tougher federal financing tests and compliance risk (KFF overview). At the same time, Medicare Advantage post-acute care management is under renewed pressure after federal investigators found plans delayed or denied rehab care and often reversed denials on appeal, sharpening tensions among MA plans, hospitals, SNFs, home health providers, and VBC organizations responsible for safe transitions and total-cost performance (STAT report). The week’s pattern is a more interventionist CMS posture: tighter Medicaid waiver financing and enforcement on one side, and escalating scrutiny of MA utilization management on the other—both of which raise operational stakes for ACOs and risk-bearing providers coordinating post-acute, home-based, and Medicaid-covered care.
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