Cost & Affordability

CMS is pushing affordability through more aggressive payment-model levers: the finalized GLOBE drug payment model extends most-favored-nation-style pressure into Medicare Part B drugs, while renewed attention to the CJR model’s reported $180M in savings strengthens the case for expanding mandatory or quasi-mandatory episode-based payment beyond joint replacement. For ACOs, health systems, and MA-focused organizations, the signal is a tighter cost-control environment under the Trump administration—drug pricing, bundles, chronic specialty care, and MA overpayment scrutiny are converging as policymakers look for scalable savings while preserving quality and beneficiary access (GLOBE drug pricing model; CJR savings and expansion case).