Medicare & Medicare Advantage
Expert articles and analysis related to medicare & medicare advantage.
AI Summary — Last 30 Days
Synthesis:
Over the past 30 days, CMS has accelerated value-based care transformation with major moves including the nationwide expansion of the mandatory joint replacement bundled payment model (CJR-X), signaling a return to mandatory episode-based models and a focus on managing musculoskeletal spend at scale (CMS Proposes Resurrection and Nationwide Expansion of Mandatory Joint Replacement Bundled Payment Model (CJR-X)). Simultaneously, CMMI has launched the ACCESS model, opting for unusually “lean” payment rates and awarding access to over 150 digital health companies and providers, as part of its “Make America Healthy Again” vision that prioritizes taxpayer protection alongside prevention and care innovation (Lean payment, voluntary participation test new ACCESS model). These directions reflect the Trump administration’s push for accountability, competition, and technology-driven partnership models, heightening both opportunity and pressure for ACOs, payers, and providers to adapt to more rigorous benchmarks and diversified payment arrangements.
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