Medicare Payment Policy
Expert articles and analysis related to medicare payment policy.
AI Summary — Last 7 Days
CMS is tightening Medicare payment policy across both Medicare Advantage and alternative payment models: the 2027 MA rate announcement is being read by providers as an effort to curb MA plans’ perceived payment advantage, while Clover’s Star Ratings litigation win underscores ongoing legal and actuarial volatility around MA quality bonuses and plan revenue. At the same time, CMMI’s mandatory TEAM episode model, the ACCESS model, the Increasing Organ Transplant Access Model, and Home Health Value-Based Purchasing signal continued federal pressure to move providers into risk-bearing, data-driven care redesign under the Trump administration’s CMS leadership. For ACOs, hospitals, post-acute providers, and MA-facing physician groups, the week’s pattern is clear: Medicare payment policy is becoming less forgiving of passive participation and more dependent on coding accuracy, quality measurement defensibility, technology infrastructure, and specialty-specific episode management (HFMA on MA payment policy; Databricks on CMS TEAM readiness
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