Medicare Programs
Expert articles and analysis related to medicare programs.
AI Summary — Last 30 Days
CMS is accelerating Medicare value-based payment under the Trump administration through a mix of voluntary tech-enabled chronic care and renewed mandatory episode-based models: the ACCESS model has accepted 150+ providers and digital health companies to test outcomes-based payments for Original Medicare beneficiaries with obesity, diabetes, musculoskeletal pain, and depression, while proposed CJR-X would revive and expand mandatory joint-replacement bundles nationally. The strategic signal is a broader CMMI push to scale VBC beyond MSSP and traditional ACO infrastructure—using “lean” payments, technology partners, and tighter hospital–post-acute coordination—while creating tension over whether payment rates and mandatory participation will be sufficient to drive provider investment without increasing financial exposure. For ACOs, specialty groups, hospitals, and payers, the near-term positioning question is whether to build capabilities around chronic-condition performance measurement and post-acute episode management now, as CMS tests ACCESS and considers nationwide bundled-payment expansion (ACCESS participants; CJR-X proposal).
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