Medicare Medicaid Programs
Expert articles and analysis related to medicare medicaid programs.
AI Summary — Last 30 Days
CMS is pushing Medicare and Medicaid stakeholders toward more standardized, measurable VBC infrastructure: the Trump administration finalized the mandatory nationwide Comprehensive Care for Joint Replacement Expanded bundled payment model while also tightening prior authorization transparency and advancing FHIR-enabled electronic prior authorization across MA, Medicaid managed care, and marketplace plans. At the same time, Medicaid financing is becoming a strategic risk for health systems as the 2025 reconciliation law’s limits on state directed payments could reduce hospital-related Medicaid funding in at least 37 states, increasing pressure to manage total cost of care and renegotiate payer-provider economics. For ACOs, hospitals, and payers, the near-term signal is clear: more mandatory episode-based payment, more utilization-management visibility, and more scrutiny of Medicaid supplemental financing will reshape VBC contracting and population health investment priorities. CJR Expanded final rule
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Coverage Isn’t Enough — Maximizing Access to Diabetes Technology in Medicaid Center for Health Care Strategies
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States target big employers as Medicaid work requirements loom
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Comment Letter: Community Engagement Requirement for Certain Individuals - MACPAC - Advising Congress on Medicaid and CHIP Policy (.gov)
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