Healthcare Revenue & Finance

Synthesis:

Over the past week, the value-based care landscape has seen major momentum from CMS under the Trump administration with the proposed FY27 rule to expand the Comprehensive Care for Joint Replacement (CJR) bundled payment model to virtually all hospitals, signaling a shift toward mandatory value-based payment at national scale and increased financial accountability for providers. Simultaneously, finalized updates to the Part D risk adjustment model are set to alter plan payments and risk profiles for Medicare Advantage and Part D plans, intensifying the need for advanced data management and contract strategy among payer organizations. These developments underscore heightened federal pressure on all VBC stakeholders to accelerate adoption, optimize risk management, and address structural challenges in payment model design and implementation. See details: CMS FY27 rule expands bundled payments, 2027 Part D Risk Adjustment Changes Will Alter Plan Payment.