Healthcare Cost & Affordability
Expert articles and analysis related to healthcare cost & affordability.
AI Summary — Last 24 Hours
In the last 24 hours, CMS has proposed a nationwide, mandatory episode-based payment model—CJR-X—for joint replacements, requiring most hospitals to assume accountability for total Medicare spending across joint surgery episodes, signaling a stronger federal push toward bundled payments and cost containment in Medicare CMS proposes mandatory hospital-bundled model for joint replacements. Meanwhile, California continues to advance bold multipayer primary care payment reforms within Medi-Cal, including calls for unified network administration, integrated in-home support, and AI-enabled health data infrastructure, reflecting mounting state-level pressure to modernize payment models and coordination for Medicaid populations Medi-Cal Bold Idea — Multipayer Primary Care Payment Reform Model. These actions, led at both federal and state levels, create immediate opportunities—as well as operational and compliance tensions—for value-based care organizations, ACOs, and payers navigating shifting risk arrangements and delivery system redesign.
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From newsletter: Beyond the Data from Drew Altman: Affordability Is the Issue, But Look for the Uninsured to Make a Comeback Beyond the Data from Drew Altman: Affordability is the Issue Now, But Loo...