Medicare Policy
Expert articles and analysis related to medicare policy.
AI Summary — Last 30 Days
CMS is pushing Medicare value-based care toward a more mandatory, infrastructure-heavy phase: the proposed nationwide redesign of CJR for hip and knee replacements, the ongoing TEAM model, and the new LEAD ACO design all signal that providers will face broader episode-based and longitudinal accountability, with less room to remain purely voluntary participants. At the same time, the Trump administration’s CMS is tightening the Medicare Advantage payment environment—addressing MA plans’ perceived coding and payment advantages—while also testing technology-enabled utilization management, creating a strategic tension between curbing overpayment, expanding accountable care, and managing provider concern over administrative burden and AI-driven prior authorization. For ACOs and health systems, the key positioning issue is whether to build durable care-management, data, and contracting capabilities internally or rely on conveners and enablement firms as models like [LEAD](https://news.google.com/rss/articles/CBMiggFBVV95cUxQMjMwak1tRDRZS2lVam5pcXNYd2IxVS1ROWpGYXdGS2RYQUZwNUNYSExIZ092Z092bFMyV0dfNld0QV9rbG5GZnNkbmxXWENPQVZwUWxKbkF6Z09pWHg0NHdVdkJHUmpuS2luVUZNREZHdGdMNGxsTmk1SjRmSndHMnpR0gGSA
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