Healthcare Market Dynamics

CMS’ ACCESS model is drawing health-tech entrants like Oura and Counsel Health to test whether wearables, AI-enabled triage, and longitudinal virtual support can scale chronic care management—signaling that CMMI’s VBC agenda under the Trump administration is leaning into tech-enabled population health infrastructure, not just provider payment redesign (Fierce Healthcare). At the same time, Medicare Advantage market exits and footprint cuts—including HCSC’s pullback after the Cigna deal—underscore tightening MA economics and network/capital discipline, while KFF flags Medicaid managed care rate-setting uncertainty under the 2025 reconciliation law as another source of plan-exit risk (KFF). For VBC leaders, the week’s pattern is a widening split: CMS is expanding experimentation around AI-enabled care management, but payer participation in risk-bearing markets is becoming more selective as reimbursement, utilization, and regulatory math pressure margins.