Medicare Payment Advisory Commission
Expert articles and analysis related to medicare payment advisory commission.
AI Summary â Last 30 Days
In the last 30 days, the Centers for Medicare & Medicaid Services (CMS) has intensified its push for value-based care through the introduction of new models, including the upcoming Long-term Enhanced ACO Design (LEAD), which will link quality performance to benchmark funding after ACO REACH concludes in 2026. This shift responds to growing demand from nursing homes for more equitable ACO participation, as 90% are currently left out of the existing frameworks, creating tensions in care alignment and population health management. The Medicare Shared Savings Program continues to gain traction, exemplified by Community Care Cooperative's recent achievement of $10.2 million in shared savings, underscoring the financial viability of ACOs in achieving quality care and cost efficiency despite the evolving landscape of payment models, including the impending Ambulatory Specialty Model slated for 2027.
Related Articles
CMS receives record comments on controversial Medicare Advantage payment proposal
The Trump administration wants to keep MA rates flat next year and change how risk adjustment is calculated. Insurers had a lot to say about this, CMS officials shared Tuesday during an event in D.C.
Humana Introduces New Value-Based Cardiology Care Partnerships for Medicare Advantage Members
Humana Introduces New Value-Based Cardiology Care Partnerships for Medicare Advantage Members  Yahoo Finance
CMS threatens Elevance with Medicare Advantage sanctions
CMS threatens Elevance with Medicare Advantage sanctions  Healthcare Dive
CMS threatens Elevance with Medicare Advantage sanctions
Federal regulators are planning to suspend enrollment in Elevance's MA plans at the end of March, in a rare and serious threat to the companyâs finances.
Considerations for implementing Medicare Advantage encounter data in risk adjustment - MedPAC (.gov)
Considerations for implementing Medicare Advantage encounter data in risk adjustment  MedPAC (.gov)
Considerations for implementing Medicare Advantage encounter data in risk adjustment - MedPAC (.gov)
Considerations for implementing Medicare Advantage encounter data in risk adjustment  MedPAC (.gov)
Humanaâs MaxHealth Deal Tests Medicare Advantage Strategy And Valuation Gap
Humanaâs MaxHealth Deal Tests Medicare Advantage Strategy And Valuation Gap  Yahoo Finance
The Value Shift â How Medicare Advantage Benefits Are Evolving for 2026
This updated paper builds on Wakelyâs prior analysis of Medicare Advantage benefit design, incorporating newly released 2026 enrollment data to provide a clearer picture of how market dynamics are evo...
Flat 2027 Medicare Advantage Rates Signal Tighter Budgetsâand Tougher Access Ahead
Flat 2027 Medicare Advantage Rates Signal Tighter Budgetsâand Tougher Access Ahead  Pharmaceutical Commerce
Which types of health insurers make the most money?
It turns out the answer is Medicare Advantage plans according to a KFF analysis released today. However the reason why Medicare Advantage is more profitable may not be obvious: At the end of 2024, gro...