CMMI Payment Models
Expert articles and analysis related to cmmi payment models.
AI Summary — Last 7 Days
CMS is moving CMMI toward more tech-enabled, condition-specific payment models: the Trump administration is expanding the ACCESS model in 2027 to include COPD, substance use disorder, and tobacco cessation, while adding companies such as Oura and Counsel Health to test wearables and AI-enabled chronic care management at Medicare scale (Healthcare Dive). At the same time, CMMI Director Abe Sutton is signaling that WISeR—despite provider concerns, delays, and technology failures—could become a broader template for AI-enabled prior authorization and utilization management in federal programs, creating a growing tension between innovation, administrative burden, and provider trust (HFMA). For ACOs, health systems, and payers, the emerging pattern is clear: CMS is pairing chronic-care enablement and cross-payer alignment ambitions with tighter scrutiny of “wasteful” services, making data infrastructure, specialty alignment, and patient-facing technology central to future VBC performance.
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Reducing Medicare joint replacement spending while maintaining quality - mathematica.org
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