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Medicare Program Policy

Expert articles and analysis related to medicare program policy.

192 articlesLast 30 Days

AI Summary — Last 30 Days

CMS is accelerating Medicare value-based care through CMMI models that pair chronic-condition outcomes with technology enablement: the voluntary ACCESS model launches July 5 with 150 participants and ties payment to measurable results for Original Medicare beneficiaries with obesity, diabetes, musculoskeletal pain, and depression, signaling a strategic push toward tech-enabled specialty and longitudinal care management. At the same time, CMS is moving in the opposite direction on provider voluntarism by proposing CJR-X, a mandatory nationwide joint-replacement bundled payment model beginning Oct. 1, 2027, which would place hospitals at risk for episode spending across surgery and post-acute recovery and intensify the need for hospital–home health coordination. Together, ACCESS and CJR-X suggest the Trump CMS is positioning CMMI around scalable chronic-care platforms and broader mandatory episode accountability, creating new strategic pressure for ACOs, hospitals, physician groups, post-acute providers, and digital health partners to align contracting, data infrastructure, and care redesign.

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