CMS Payment Models

CMS payment-model activity this week points to a broader Trump administration push to harden Medicare value-based care around longer-term accountability and more mandatory participation: the LEAD ACO model is drawing attention because it offers a 10-year runway from 2027–2036, but ACOs face a near-term May 17, 2026 application decision that will force strategic choices on risk appetite, infrastructure, and beneficiary management (Wakely on LEAD). At the same time, CMS is extending episode-based pressure through TEAM and a proposed nationwide redesign of CJR for hip and knee replacements, signaling that hospitals and post-acute partners should expect more mandatory bundles alongside population-based models rather than a retreat to voluntary demonstrations. The week’s commentary also shows the competitive perimeter widening beyond physician groups: nursing homes are positioning around ACO “spillover” effects, biosimilar adoption is being tied to VBP performance, and ACCESS/AI discussions suggest CMS under Dr. Mehmet Oz and CMMI Director Abe Sutton is pairing payment reform with technology-enabled primary care transformation.