CMMI Models
Expert articles and analysis related to cmmi models.
AI Summary — Last 30 Days
CMS is accelerating a shift back toward mandatory, episode-based value-based payment: the finalized Comprehensive Care for Joint Replacement Expanded (CJR-X) model would require broader hospital participation by 2028, while TEAM is positioning home health and post-acute providers to prove value through tighter discharge planning, readmission avoidance, and episode cost control. This creates a strategic tension for hospitals and ACO-aligned networks: mandatory models can standardize accountability and create scale for care redesign, but they also add material administrative burden—recent analysis pegs mandatory hospital VBP programs at roughly $3 billion annually—making operational readiness, data infrastructure, and post-acute network management central to margin protection. As Medicare Advantage plans pull back from some risk-bearing activity, CMS/CMMI models such as CJR-X and emerging primary-care models like LEAD are becoming a more important engine for VBC strategy across hospitals, home-based care, and ACOs.
Related Articles
TEAM demo gives home health opportunity to prove post-acute care value
TEAM demo gives home health opportunity to prove post-acute care value McKnights Home Care
Medicare’s Access Model Is a Worthy Experiment
Medicare’s Access Model Is a Worthy Experiment RealClearHealth
CJR-X Is the Future of Value-Based Care
January 1, 2028, is an important milestone, but CJR-X readiness is only part of it. Hospitals that take advantage of the time ahead to improve coordination across the continuum will be better position...
CMS proposes 6 updates to its Ambulatory Specialty Model for heart failure
CMS proposes 6 updates to its Ambulatory Specialty Model for heart failure Becker's ASC
CMS To Require Expanded Joint Replacement Model Participation By 2028
Client Alert: Centers for Medicare & Medicaid Services Finalize Comprehensive Care for Joint Replacement Expanded, a Mandatory Nationwide Bundled Payment Model for Joint Replacement Care
Client Alert: Centers for Medicare & Medicaid Services Finalize Comprehensive Care for Joint Replacement Expanded, a Mandatory Nationwide Bundled Payment Model for Joint Replacement Care JD Supra
Client Alert- Centers for Medicare & Medicaid Services Finalize Comprehensive Care for Joint Replacement Expanded, a Mandatory Nationwide Bundled Payment Model for Joint Replacement Care
Client Alert- Centers for Medicare & Medicaid Services Finalize Comprehensive Care for Joint Replacement Expanded, a Mandatory Nationwide Bundled Payment Model for Joint Replacement Care The National...
Bundle Up: CMS Mandates TJR Reimbursement Bundling Nationwide
Bundle Up: CMS Mandates TJR Reimbursement Bundling Nationwide Orthopedics This Week
Georgia hospitals get $93M in federal aid, but rural leaders say it won’t be enough
Georgia hospitals get $93M in federal aid, but rural leaders say it won’t be enough Atlanta News First
Indiana Medicaid To Cover GLP-1 Obesity Medications Through Federal BALANCE Model - open minds
Indiana Medicaid To Cover GLP-1 Obesity Medications Through Federal BALANCE Model open minds