CMS Innovation Models
Expert articles and analysis related to cms innovation models.
AI Summary â Last 24 Hours
CMS is tightening fiscal oversight of Medicaid Section 1115 demonstrations, moving to strengthen budget-neutrality standards and constrain waiver spendingâan immediate signal to states, Medicaid managed care plans, and provider-led VBC programs that supplemental funding and demonstration-based delivery reforms will face closer federal scrutiny under the Trump administration. At the same time, VBC risk strategy remains active on the Medicare side: Wakely is advising ACOs and provider groups in MSSP and CMMIâs LEAD Model to use stop-loss coverage to manage downside exposure, while Congress is moving to end funding for the WISeR pilot, underscoring political pressure on CMMI demonstrations that rely on utilization management or AI-enabled review tools. CMS Medicaid waiver oversight | ACO stop-loss risk strategy
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Contributor: Turning Headwinds Into MomentumâHow Value-Based Care Can Help Payers Manage Costs and Regain Stability
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CMS Takes âBoldâ Action To Make Medicaid Section 1115 Waivers Budget-Neutral
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CMS Rule Signals Shift in Medicaid State-Directed Payments
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