CMS Innovation & Payment Models

Over the past 30 days, CMS has accelerated structural changes to Medicare value-based care with the nationwide rollout of the mandatory CJR-X episode-based payment model for joint replacements, requiring hospitals to manage total Medicare spending across surgical and post-acute episodes starting October 2027—a notable expansion of bundled payments that signals increased risk assumption for providers and tighter hospital–home health coordination CMS proposes mandatory hospital-bundled model for joint replacements. In parallel, CMMI is seeking applicants to the new LEAD ACO Model, emphasizing performance-based risk and pragmatic entry points for a broader range of providers, reinforcing the Trump administration’s use of mandatory and competitive demonstrations as “big stick” levers to drive adoption of value-based care CMS seeks applicants for LEAD ACO Model.