Episode-Based Payments

CMS is increasingly being positioned as the main driver of value-based care as Medicare Advantage plans pull back from risk, creating near-term momentum for CMMI-led models—including episode-based payments and home-based care pathways—under the current Trump administration CMS leadership. The immediate tension for ACOs, providers, and payers is that CMS may accelerate mandatory or quasi-mandatory payment models just as MA organizations narrow benefits and provider partnerships, shifting more VBC strategy back toward traditional Medicare and federal model participation (Home Health Care News). Separately, Costco’s move with SCAN Group to launch Medicare Advantage plans underscores that retailers and nonprofit MA sponsors still see member-acquisition opportunities, but this is more about MA distribution and plan competition than episode-based payment innovation (Detroit News)