Payment & Delivery Reform

Synthesis:

In the last 24 hours, payment and delivery reform developments have centered on CMS’s finalization of the 2026 Outpatient Prospective Payment System (OPPS) rule, which directly impacts cardiology reimbursement structures by clarifying bundling rules and procedural coding requirements—key considerations for ACOs and population health platforms navigating episode-based payment models. Additionally, updated coding guidance for complex cardiovascular and radiology interventions highlights ongoing challenges for value-based entities managing procedural attribution, risk adjustment, and revenue integrity under evolving fee-for-service and hybrid risk arrangements (RAC Monitor cardiology update, RAC Monitor radiology update). No significant policy moves affecting VBC, ACOs, or payment models were announced from CMS or HHS in the last 24 hours.