Medicare Payment Models
Expert articles and analysis related to medicare payment models.
AI Summary — Last 30 Days
Over the past 30 days, CMS has accelerated value-based payment reform with the proposed rollout of the mandatory nationwide CJR-X bundled payment model for joint replacements, which extends hospital accountability to the full episode of care—including coordination with home health providers—beginning October 2027 (details). Simultaneously, CMS is soliciting applications for the LEAD (Long-term Enhanced ACO Design) Model starting in 2027, which introduces foundational changes for ACOs: eliminating rebasing, expanding capitation, and embedding specialist risk-sharing, thus signaling a move to lock in base years and align financial incentives over a longer horizon (summary). These shifts intensify pressure on hospitals, physician groups, and ACOs to build advanced care management and analytics infrastructure as CMS pursues larger-scale, more prescriptive models with increasing provider risk and integration requirements.
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