Medicare Programs
Expert articles and analysis related to medicare programs.
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CMS’s continued push into Medicare episode-based payment is drawing operational pushback as stakeholders scrutinize the CJR-X joint replacement expansion, with hospitals and clinical groups warning that therapy services and post-acute risk may be underweighted—an immediate concern for health systems managing bundles, discharge pathways, and downside exposure. At the same time, Medicare Advantage plans face intensifying compliance and margin pressure from RADV extrapolation and denial scrutiny, making risk adjustment governance, documentation, and utilization management controls central VBC priorities for 2026 planning (Wakely RADV guide; CJR-X takeaways).
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