Medicare Policy
Expert articles and analysis related to medicare policy.
AI Summary — Last 30 Days
CMS is accelerating Medicare value-based payment under the Trump administration by expanding condition-based and episode-based models: CJR’s reported $180M in savings is strengthening the case for broader mandatory bundled payments, while TEAM is already shifting hospitals toward outpatient substitution and tighter post-acute/home health coordination. At the same time, CMS is widening the ACCESS Model into additional chronic care tracks for 2027—including COPD, substance use disorder and tobacco cessation—signaling a longer-term strategy to pair digital chronic disease management with Medicare payment reform (ACCESS expansion).
For ACOs and provider groups, the CY 2027 Physician Fee Schedule/MSSP debate is becoming a strategic inflection point: CMS is moving to address primary care undervaluation, while stakeholders such as Premier and HCTTF are pressing for stronger accountable care incentives, lower administrative burden, and interoperability requirements that make population health management more scalable (CY 2027 PFS/MSSP comments). Parallel MA risk-adjustment audits and the finalized GLOBE drug pricing model underscore the same policy direction: more federal pressure on coding integrity, specialty/drug spending, and measurable outcomes across Medicare.
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